Application Form
OIC - COMSTECH and CEMB Research Fellowship Program for OIC Member States
Email-1
example@example.com
Submission Date
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Day
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Month
Year
1- Full Name
*
Full Name, as per passport
2- Nationality
*
3- Gender
*
Please Select
Male
Female
4- Current Country of Residence
*
5- Religion
*
6- Email
*
example@example.com
7- Date of birth
*
-
Day
-
Month
Year
8- Passport number
*
9- Expiry Date (Passport)
*
-
Day
-
Month
Year
10- Marital status
*
Please Select
Single
Married
Divorced
Widowed
11- Number of children (if any)
*
12- Current address
*
13a- Details of education (Please state your Highest degree, institution, grade),
*
13b- Upload clear scan of degree / transcript
*
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14- Details of any previous visits abroad
*
0/100
15- Proof of English language proficiency (tick the relevant)
*
Please Select
Not Proficient
Average
Proficient
16a- Medical fitness
*
*Declare any medical condition you have (this will not affect the outcome of your application.
16b- Medical fitness
*
*Declare if you or your partner are expecting a child.
17- Current/previous employment
*
*Name of the organization/employer and your Job description
18- Why do you want to avail this fellowship/training program and why are you a good fit? (at least 200 words)
*
0/200
19- What are your research/training objectives? Please write details of the research/training you wish to conduct (at least 200 words)
*
0/200
21- Scan of one recommendation letter (current/most recent Institution)
*
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22- Upload Clear scan of passport
*
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The file should be in .pdf or .jpg format only. File size must not exceed 300kb
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23- A detailed CV enlisting all educational/professional activities, research publications and a clear picture, from not more than 6 months ago.
*
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Declaration
*
By signing this form, you acknowledge that all the information provided is true, and agree to comply with all terms and conditions of this fellowship.
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