University of debrecen (fi 17198) /201

UNIVERSITY OF DEBRECEN (FI 17198) …………/201...........

APPLICATION FORM

First Name: …………………………………… Family Name…………..…………………….

Sex: Male / Female

Name at Birth: …………………………………………………………………………….........

Neptun Code (only for students of the University of Debrecen):…………………………...................

Place of Birth: Date of Birth:

Mother’s Maiden Name: …………………………………… Nationality:

Identity Card Number: ………………………………………………………………………….

Permanent Address:

Postal Address:

E-mail:

Place of Work:

University Degree major:

qualification: ....………………………………………...................................

name of the institution:…………………………………………………….

Language proficiency (languages, levels, certificates, number and date of certificates):

Previous scientific activities (in numbers): … Student Science Circle essay; … publication; … review article; … conference lecture; … other (e.g. participation in programs for talented students): …………………………………………………………………………………………….…………

Have you ever participated in any PhD courses or degree courses at UD or any other institutions?

a) No b) Yes, the following(s):
III. Name of the PhD Course to be applied for

Name of the Doctoral School:

The proposed title of the study:

Name of Supervisor:

Type of Course: Full Time – Correspondent

Date: ………………………, 201... signature of the applicant


Documents Required for the Application:

• 
  a copy of the MSc Degree (if it is not available yet an official certificate about the expected DATE and RESULTS of the final exam obtained from the Education Office
  

• 
  students from foreign universities must present a copy of their degree together with a certified Hungarian translation (after acceptance)
  

• 
  a copy of at least one complex (oral and written) state accredited language proficiency exam certificate (level B2)
  

• 
  research proposal with the approval of the supervisor
  

• 
  professional CV together with a list of publications
  

• 
  statement about clean criminal record
  

• 
  2 pieces of self-addressed and stamped small size ENVELOPE for priority mail
  
• 
  evidence of payment of HUF 9000 application fee
  

Debrecen, ….…………….. , 201..

(signature of the supervisor)

A felvételi elbeszélgetés eredménye:

szakmai intelligencia pontszáma: . . . pont

a diploma minősítésének pontszáma . . . pont

eddigi tudományos (TDK) munka utáni pontszám: . . . pont

A bizottság javaslata: feltétlenül - feltételesen - nem javasolja

Debrecen, 201.. ……………… …..

(vizsgabiztos aláírása) (a programvezető aláírása)

a) Felvételt nyert a Doktori Iskolába

Témavezető:

Téma/doktori program

b) Nem nyert felvételt: helyhiány miatt - nem felelt meg

Debrecen, 201.. ….……………. …..