- UNESCO Regional Bureau for Science in Europe -
- Georgian Academy of Sciences - Tbilisi State University -

ISPM-UNESCO (ROSTE) SHORT-TERM FELLOWSHIP 2005

Application Form

Deadline for submission: August 15, 2005.
Family Name:
First Name:
Citizenship:
Date of birth:
19 (e.g. 1978)
Gender:
Male Female
Educational Level:

Name of university graduated from, post-graduate course passed, scientific degree

Professional Background:

Short description of professional experience after the graduation from university.

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

Knowledge of foreign languages:
Address:
Institution
Street
City
Postal code
Country
Phone
Fax
E-mail
Application for
Full financial support for local expenses only (conference fee, logging, meals and local transportation)
Full financial support for local expenses and partial payment of travel.
Please indicate the cheapest cost of your travel in USD and how much travel support you are requesting:

Full financial support for local and travel expenses.
Please indicate the cheapest cost of your travel in USD:
Date of arrival:
2005
Date of departure:
2005
If you wish to present a talk give a title:
If you wish to present a talk provide an abstract:

Note. Brief, plain text abstracts are preferable.

Brief professional CV:
List of publications:
Senior Scientist supporting this application:
Full name
Position
Address
Any comments:


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