Coming up

You are here: Home > PhD > Application

Applicationform PhD-training

Family name:
First name:		Title:
Date of birth:			Male: Female:
Institute		Department
Working address:		Room:
Zipcode:		Place:
Business phone:		Fax:
E-mail address
Address privé		Home phone:
Zipcode:		Place:
You are:
= AIO; = OIO; = AGIO/AGNIO		= Other:

Title research project:
Promotor:
Supervisor:

Date of appointment:	(yyyy-mm-dd)
Appointment ends on:	(yyyy-mm-dd)
Financing:	= Fac VET - PHAR - NED (AZU-WKZ)
	= NWO
	= Collecting box fund
	= Industry - EU ministry - Econ.Aff or WVS - contract research
	= Others:

Vakken waarin tentamen is afgelegd op pre-doctoraal niveau:	= Fysiologie, = celbiologie, = moleculaire biologie, = biochemie, = pathologie, = immunologie, = microbiologie, = biostatistiek
Specialization:
Microsectie number: