中丹联合培养博士生项目申请表(英文)-JOINT-DOCTORAL

JOINTDOCTORALPROMOTIONPROGRAMME(DPP)REGISTRATIONFORMPERSONALINFORMATIONAttachPhotoMiss/Ms/Mrs/MrRegistrationnumber(pleaseleaveblank)Surname(FamilyName),FirstName(GivenName)NationalityGenderMaritalStatusDateofBirth(day,month,year)□Male□Single□Female□MarriedPlaceofBirthNumberofChildren:____CorrespondenceAddressAddresstowhichallcorrespondencewillbesentPermanentHomeAddress(ifdifferentfromcorrespondenceaddress)AddressTelephoneFax(ifapplicable)EmailACADEMICHISTORYHighereducationinstitutesattended(university,polytechniccollegeorother)Dates(mm/yy–mm/yy)NameofInstitution/Place/CountryPrincipalSubject(s)DegreesawardedorexpectedbeforejoiningtheDPPDateofAward(day/month/year)ExactDegreeTitle(BSc,MSc,Diplomaetc.)SubjectScore(Marks,Points)ObtainedMax.*Min.**Maximumscore(marks,points)thatcanbeobtained,**Minimumscore(marks,points)requiredtopassHONOURS,SCHOLARSHIPS,PRIZESListanyhonours,prizesandawardsyouhavereceivedrelevanttothisapplication,withdatesandshortdescriptionTHESISTitleofyourMasterorDiplomathesis,alsoindicatethenameofyoursupervisorLISTOFPUBLICATIONS,PATENTSETCREFERENCESFirstRefereeSecondRefereeName:Occupation:Address:Phone:Fax:Email:LANGUAGESKILLSLanguagenativeverygoodgoodfairpoorEnglishDanishEnglishScore(s)DateIELTSTOEFLOther(pleasespecify)OtherinformationprovingEnglishproficiency:OTHERRELEVANTINFORMATIONORREMARKSRESEARCHPROPOSAL1)PROPOSALFORCANDIDATESWITHSUBJECTFORPH.D.THESISANDPH.D.SUPERVISORINCHINATitleofyourPh.D.thesisPh.D.SupervisorName:Position:Address:Phone:Fax:Email:Nameofuniversityyouwouldliketogoto/thatfityourscientificinterest:a)Name:Supervisor:Address:Phone:Fax:Email:b)Name:Supervisor:address:Phone:Fax:Email:c)Name:Supervisor:address:Phone:Fax:Email:Writeashortresearchproposalonthescientificworkyouwouldliketodoifyouhadtherelevantresourcesandequipment.Youarewelcometodevelopyourownideas.Alternativelyyoumaylookuprecentpublicationsofrelevantmembersoffacultyasastartingpoint.FAMILYINFORMATIONThesedetailsareneededincaseyourfamilywilljoinyouduringyourstayinDenmarkDoyouwantyourfamilytojoinyouduringyourstayinDenmark?□Yes□NoSpouse:Surname(FamilyName),FirstName(GivenName)DateofBirthPlaceofBirthChildren:Surname(FamilyName),FirstName(GivenName)DateofBirthPlaceofBirthSurname(FamilyName),FirstName(GivenName)DateofBirthPlaceofBirthNOTESFORGUIDANCEBeforecompletingthisregistrationform,pleasereadthefollowinginformationcarefully.1.PleaseuseA4sizepaperonlyanddonotstaple.2.Pleaseeithertypeorcompletethisformbyusingblockcapitalsthroughout.Completeallsectionsoftheregistrationasfullyaspossible.IfasectiondoesnotapplytoyoupleaseindicatethiswithN/Afornotapplicable.3.Pleasedonotaddanyoriginalcertificates.STATEMENTIcertifythattheinformationprovidedinthisregistrationformisaccuratetothebestofmyknowledge.Iamawarethatfalseanswers,whetherintentionalortheresultofnegligence,areillegalandthattheirdiscoverywillleadtotherevocationofmyregistration.PlaceDateSignature