ISPM-UNESCO (ROSTE) SHORT-TERM FELLOWSHIP APPLICATION FORM
(Only young researchers and PhD students 
with age not more than 35 years are admitted)

Course No: (Indicate activity title and dates)

1. Family name:
2. First name:
3. Citizenship:
4. Date of birth:
5. Educational level:
	Name of university graduated from
	Post-graduate course passed
	Scientific degree
6.Professional background: 
	(short description of professional experience 
	after the graduation from university).
7. Present scientific-teaching position
	(name of the institution, laboratory, position occupied, 
	name of the head of laboratory or institution, 
	brief description of current research activities)
8.Knowledge of foreign languages

9.Institution

10. Address: 
	City........, 
	Postal code........, 
	Country, 
	Tel:......,
	Fax:......., 
	E-mail
11. Senior scientist supporting this application:
	Full name:
	Position:
	Address: 
	including tel., fax numbers and E-mail
12. Application for: 
	Full financial support 
	(please indicate the cheapest cost of your travel in USD).........
	Financial support with partial payment of travel
	(please indicate the cheapest cost of your travel in USD)............
	Full financial support for local expenses 
	(logging and meals, and local transportation)...............

Signature and date.................................................

Note: 
Please, attach your professional CV with passable references 
and the list of publications.