Application form - TIMUR

By Monica Greene,2014-02-06 23:23
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Application form - TIMURForm,form,Forms,forms

     Application form TIMUR Cohort 1

    The latest date for starting student mobility must be 31 December 2014

    This application form should be completed in block letters (in ENGLISH) in order to be easily copied and/or faxed.

    1. General Information 1.1. Please mark Attach photo Target Group 1 (Partner University) Please do not staple! 2. 1.2. Application for (please mark only one Mobility type and one duration)

    3. Undergraduates 10 months

    4. Masters 12 months*

    5. Doctorates 24 months ** 36 months

    6. Post Doctorates 6 months 10 months

    7. Academic Staff 1 months 2 months OR

1.3. Please mark

     Target Group 2 (Applicant from an Institution, which is not a Member of the Partnership)

    8. 1.4. Application for (please mark only one Mobility type and one duration)

    9. Masters 12 months 24 months

    10. Doctorates 24 months** 36 months

    11. Post Doctorates 6 months 10 months

    12. Academic staff 2 months


1.4. Please mark

     Target Group 3 (Applicant who is in particular vulnerable situation)

    13. 1.5. Application for (please mark only one Mobility type and one duration)

    14. Undergraduates 36 months

    15. Masters 24 months

    16. Doctorates 24 months** 36 months

    17. Post Doctorates 10 months

    1.3. Application for Thematic field Agriculture Science

     Natural Resources Management

     Climate Change Adaptation

     Geography, Geology

     Mathematics, Informatics

     Natural Science

     Education, Teachers’ training

     Engineering & Technology

     Business , management and economics

     Others i.e.

1.4. Current occupation BSc student

     MSc student

     PhD student


     Academic Staff

     Administrative Staff at University

     Others i.e. 1.5. Home Institution, City

1.6. If you are a Student

- Field of Study


- Faculty

     - Years of study, previous to planned


    - Subject Code (will be filled in by local


2. Applicant?s personal data

- Family name (same names as in the passport)

    - First name

    - full address (Street + number, Post code, City)

    - Number of International Passport

    - Expiry date of passport

    - Mobile number

    - E-Mail

    - Date of birth

    - Place of birth, Country

    - Sex Male


    - Citezenship Uzbekistan


    - Family status/ no of children

    3. Coordinator at local /home university (name, phone number, Email address)

4. Host EU Institution

    Institution, Country Preferred Start of study Field of Studies (max 2 study Duration of

    Month / year programmes) please provide exact stay in

    name of programme months 1st priority

    2nd priority

5. Secondary School Education

     5.1. Name of the School From…….to…………..

5.2. Final school certificate

    - Exactly Date (e.g. 12.06.2009)


- Original name of document

    - Country

6. Higher Education (incl. study abroad)

Please note that documents from local language have to be translated into English. In this case the

    certificates in the original language have to be accompanied by an official translation (for Masters,

    Doctorates, Post Doctorates)

    Programme of study Institution and country Period

    7. Foreign Language Competence

    What is the score? 7.1. Which ENGLISH language certificates do you




     Cambridge Certificate of Advanced English

     Other, please specify

     NO certificate yet Expected date and name of certificate

    In this language I can participate I have sufficient knowledge I would have sufficient 7.2. Other languages active in scientific. discussions to follow knowledge to follow lectures if I without difficulties had some extra preparation

     yes yes yes

     no no no

     yes yes yes

     no no no

     yes yes yes

     no no no

8. Recommendation letters

     Please add 2 recommendation letters in a separate document!

Professor 1:

    - Title, Name

    - Institution

    - Subject of the professors

    Professor 2:

    - Title, Name

    - Institution

    - Subject of the professors

    9. Have you been awarded with an Erasmus Mundus External Cooperation Grant?


     Yes, if yes, when , at which university for how long?


    10. Only for candidates applying for PhD, Post Doc or Academic Staff scholarship


    Please specify your obtained last degree and the specific research you want to do at a EU-

    University. Please add separate document on your research proposal

- Degree (Master, PhD, others)

    - Proposed Research on

    - Currently affiliated with (Institution)

    - confirmation of acceptance from host university: Yes


10.2. Degrees held

     Date Exact degree title Subject Result

     I certify that the information in this application is accurate. I do not have any psychical diseases and disabilities, which

    would compromise my participation in the Erasmus Mundus Action 2 Strand 1 Partnerships Training of Individuals

    through Mobility from Uzbek Republic to EU “(TIMUR). I certify that I will inform about personal changes and additions immediately to the Coordinator of the Erasmus Mundus Action 2 „TIMUR”. I agree that this application and enclosed

    documents can be forwarded to collaborating Institutions, which are cooperating in this programme.

If you find out you are pregnant, please inform the EU Institution as soon as possible in order to discuss the situation

    with both the EU Institution and TIMUR project.

     Place and date Signature of the applicant

    Acknowledgement of receipt

     ID Number:

     Place and date Signature of TIMUR

    Steering Committee


     University stamp Name


    * for students seeking EU diploma with MA thesis research performed at home university

    ** for PhD sandwich construction


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