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Application form PhD course
Utrecht University Graduate School of Life Sciences
Course:
Time:
Dates:
Course presenter:
EC:
Costs:
Writing for Academic Publication 2015 - I
Thursdays, 13:00 – 17:00h
February 26, March 5, 12, 19, 26, April 2, 9, 16, 23, 30, 2015
Linda McPhee
3.0
Free of charge for PhD candidates Graduate School of Life
Sciences ánd working at the Faculty of Veterinary Medicine,
Faculty of Science or UMC Utrecht
For others: € 850.Venue:
Utrecht Science Park – de Uithof
Deadline for application: January 30, 2015
1.
PhD candidate
Name:
Department:
Starting year:
Email address:
Mobile phone number:
2.
Supervisor
Name:
Department:
3.
Faculty / Institute of employment of the PhD candidate
Faculty of Veterinary Medicine, Utrecht University
Faculty of Science, Utrecht University
UMC Utrecht
Hubrecht Institute
Other
4.
PhD programme to which the PhD candidate is registered
Biomembranes
Cancer, Stem Cells & Developmental Biology
Cardiovascular Research
Clinical & Experimental Neuroscience
Clinical & Translational Oncology
Computational Life Sciences
Drug Innovation
Environmental Biology
Epidemiology
Infection & Immunity
Medical Imaging
Molecular Life Sciences
1
Regenerative Medicine
Toxicology & Environmental Health
None of the above
5.
Billing address*
For candidates of the faculty of Veterinary Medicine:
Department:
Address:
Contact person (supervisor or daily supervisor):
For candidates of the faculty of Science:
Department:
Address:
Contact person (supervisor or daily supervisor):
WBS-nr.:
For candidates of UMC Utrecht:
Department:
Address:
Huispostnr:
Contact person (supervisor or daily supervisor):
6.
Signature
Signature:
Date:
…………………………………………………………………………………………………………………………………………………………
Terms and conditions:
-
Only completely filled in and signed applications (both PhD candidate and supervisor) will
be considered.
A minimum of 6 course participants is required. At the latest two weeks before the start of
the course applicants will be notified if the course continues.
*If you cancel your application after the registration deadline you will be charged €425
(no-show fee).
Scan the signed application and send the scanned document via email to Kim van den HeuvelTaverne: [email protected].
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