Cologne/Bonn Academy in Exile
Personal Information Sheet - Please avoid multiple submissions and use the option to save and complete the form later!
Name
*
First Name
Last Name
Date of Birth
*
-
Monat
-
Tag
Jahr
Datum
Place of Birth
*
Nationality
*
Current Location
*
Email:
*
Phone
*
Risk Status
*
(Risk situation, forms of state repression/forms of academic repression)
Current/Last Academic Degree
*
Last University/Employer
*
Teaching Languages
*
Teaching Experience (years)
*
Subject Area/Research Area
*
Most Reputed Academic Publications after 2010 (max.5)
Bachelor: Year/University/Discipline
Master: Year/University/Discipline
PHD/Dissertation/Kandidat Nauk: Year/University/Discipline
Title of PhD-Thesis/Dissertation
Habilitation/Postdoc-Qualification/Doktor Nauk (if applicable): Year/University/Discipline
Titel of Post-Doctoral Thesis:
Academic Conferences/Awards/Honors/Funding/Memberships
What is your current funding situation?
*
No Funding
Private Capital
Fellowship/Research
Short-term Grant (< 1 year)
Long-term Grant (> 1 year)
Contracted Position
Other
In case of fellowship/contract/other: further details
Which fellowship? Under contract where? What type of funding?
Did you already apply for a funding/support program and if so, for which?
Do you need help with applying for funding?
No, I am fine
Yes, I need advice and support
Yes, and I need to find a host/partner
What is your intended research focus/project for the next months?
*
Brief description of planned research (max 600 words)
0/600
Optional: You may upload a max. of two files (up to 10MB each)
Choose a file
Cancel
of
Speichern
Submit
Should be Empty: