Hybrid PhD Program: PhD Program Application

PhD student's details

First name

Family name

Mothers' maiden name

Gender

Date of birth

Place of birth

Nationality

Phone number

E-mail address

Permanent address

Postal code

Country

City

Street, house number

Notification address

Postal code

Country

City

Street, house number

Name of the University

(if multiple, list each of them in chronological order)

Name of the University
	Name of the University	Item weight

more items

(Expected) year of graduation

Are you already working in healthcare?

Yes

No

If yes, where and what

Are you already affiliated as a PhD student?

Yes

No

If yes, which doctoral school and university?

If yes, since when? (date)

Are you already a resident?

Yes

No

If yes, name of the institution?

If yes, since when? (date)

Are you already a lecturer?

Yes

No

If yes, since when? (date)

If yes, where?

Are you already a researcher?

Yes

No

If yes, since when? (date)

If yes, where?

Chosen Doctoral School (if there is one)

Knowledge of Foreign Languages (level)

Do you have a TDK student?

Yes

No

If yes, name of the TDK student

If yes, e-mail of the TDK student

CV

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Supervisor's details

Do you have a supervisor?

Yes

No

Supervisor's name

Supervisor's e-mail address

Supervisor's phone number

Supervisor's institution or university

Supervisor's faculty

Position

Can your supervisors participate in our weekly group meetings?

Yes

No

Is any of your chosen supervisor already a supervisor?

Yes

No

If yes, which doctoral school and university?

If you have another supervisor, mention it here

( name, email, institution or university ... )

Title of the PhD topic

Area of interest

List the topics you are interested in

List the topics you are interested in
	List the topics you are interested in	Item weight

more items

Billing details

*if it matches the data of the trainee, do not fill in*

Postal code

Country

City

Street, house number