Application Form Master/Doctorate

This Word version IS A BACKUP DOCUMENT ONLY that will hel !o" reare and easier the #o$letion o% the online ali#ation %or$& A%terwards'
!o" $a! #o!(aste the )athered in%or$ation to the online ali#ation %or$&
The online Ali#ation *or$ will +e availa+le on the ro,e#t-s we+site. The ali#ation MUST BE *ILLED IN EN.LIS/.
T/E ONLY 0ALID APPLICATION WILL BE T/E ONE SUBMITTED ONLINE1
Master mobility
Full Master
Doctorate mobility
Full Doctorate
Target Group 2 Latin American candidates
1. Applicant personal details
Personal Details:
Surname/Family ame (text, 100 characters) Compulsory
Forenames/Gi!en ames (text, 100
characters)
Compulsory
Date"o#"$irt% (day-month-year) Compulsory
Place o# &irt% (text, 100 characters) Compulsory
ationality Compulsory
Gender: (check-box): Male/Female Compulsory
'denti#ication Document Compulsory
(arried (check-box): Yes/No Optional
um$er o# c%ildren (numeric) Optional
Permanent Address
Street (text, 100 characters)
Number (alphanumeric, 10 characters)
Post Code (numeric, 10 characters)
City (text, 100 characters)
Country (text, 100 characters)
Compulsory
)ontact Details:
*mail (text, 100 characters) Compulsory
Alternati!e *mail (text, 100 characters) Optional
Telep%one (numeric, 100 characters) Optional
Additional 'n#ormation:
' declare ' %a!e not resided nor carried out
my main acti!ity +studies, -or., etc./ #or
more t%an a total o# 12 mont%s o!er t%e
past #i!e years in one o# t%e *uropean
countries. (check-box)
Yes, I confirm / No, I dont confirm
Compulsory
0o- did you get to .no- t%e pro1ect (text,
500 characters)
Compulsory
0a!e you applied at t%e same time to ot%er
#inancial support +Pro1ect #unded $y t%e
*uropean 2nion or ot%er/ (check-box)
Yes / No
If yes, please specify !ic! financial support"
(text, 500 characters)
Compulsory
Are you in a particularly !ulnera$le socio"
economic situation3 (check-box)
Yes / No
Compulsory
If yes, please upload in section #$ocuments to
%pload& 'mandatory( a formal document
'dated, si)ned and stamped by t!e issuin)
entity( t!at specifically pro*es your *ulnerable
situation" In case you fail to do so e ill not
consider you as a candidate in particularly
*ulnerable socio+economic situation"
Do you %a!e any p%ysical disa$ility3
(check-box)
Yes / No
If yes, please specify !ic! p!ysical disability"
(text, 500 characters)
Please upload in section #$ocuments to
%pload& 'mandatory( t!e document t!at
specifically pro*es your actual status of
p!ysical disability" For e,ample: declaration of
!onor from a doctor- recent medical e,am- etc"
In case you fail to do so e ill not consider
you as a candidate it! a p!ysical disability"
Compulsory
Are you in particularly !ulnera$le
situations, #or social and political reasons
+i.e. %a!ing re#ugee or asylum status4 %a!e
Compulsory
$een t%e o$1ect o# un1usti#ied e5pulsion
#rom uni!ersity on racial, et%nic, religious,
political, gender or se5ual inclination or
$elong to an indigenous population
targeted $y a speci#ic national policy/3
(check-box)
Yes / No
2. 0ome 'nstitution
*nrolled 'nstitution
6##icial name o# t%e %ome institution
'te,t, .// c!aracters(
Compulsory
'for master
mobility and
doctorate
mobility(-
Optional 'for
full master
and full
doctorate("
)ountry Compulsory
'for master
mobility and
doctorate
mobility(-
Optional 'for
full master
and full
doctorate("
'denti#ication o# t%e entity/person supporting your application at your %ome institution
Faculty/Sc%ool (text, 500 characters) Optional
Department (text, 500 characters) Optional
ame o# t%e responsi$le person
(text, 500 characters)
Optional
Position o# t%e responsi$le person
(text, 500 characters)
Optional
*mail o# t%e responsi$le person
(text, 500 characters)
Optional
6t%er contact (text, 500 characters) Optional
'n case you are currently enrolled in a programme/degree course in your %ome institution, please indicate:
ame o# t%e programme/degree course you
are currently enrolled in (text, 500
characters)
Compulsory
'for master
mobility and
doctorate
mobility(-
Optional 'for
full master
and full
doctorate("
7. Academic &ac.ground
Academic 8uali#ications
Please indicate the main academic background/qualifications or training developed until this moment that are relevant to
this application, starting with the most recent ones Please include onl! the academic training achieved in a higher
education institution
Proof of all academic qualifications must be provided" please upload a cop! of the official documents in section
#Documents to $pload%of this application form
Academic Degree A-arded 'drop+don list(
%nder)raduated/0ac!elor
Master
Compulsory
$octorate/P!$
Post+$octorate
)urrent State: 'drop+don list(
Currently bein) attended 'lease pay attention
to the !act that you must upload in section
"#ocuments to $pload% the
certi!icate/declaration o! enrollment in a
ro&ramme 'ourse)
Concluded 'lease pay attention to the !act
that you must upload in section "#ocuments to
$pload% the certi!icate o! conclusion o! the
de&ree 'ourse)
Compulsory
Title 'te,t, 1./ c!aracters( Compulsory
'nstitution 'te,t, 1./ c!aracters( Compulsory
)ountry 'te,t, ./ c!aracters( Compulsory
Date o# a-ard:
Year 'drop+don list(
Mont!'drop+don list(
Compulsory
Grade o$tained +i# applicaple/ 'alfanum2rico,
3/ c!aracters(
Compulsory
"(## N)* ('(#)+,' #)-.))% in!ormation / i! applicable
9. Pro#essional *5perience
Pro#essional/*mployment :e#erences
&riefl! describe the nature of !our emplo!ment e'perience, particularl! the relevant details for !our mobilit! proposal
(f !ou don)t have an! emplo!ment e'perience, click on *+ave, without writing an! information
)urrent main acti!ity:
Acti!ity 'drop+don list(
Student
Professor/4cademic Staff 'full+time(
5esearc!er 'it! a permanent lin6 it! t!e
!ome institution(
Optional
6t%er: 7!ic! 'te,t, 8/ c!aracters(
Department/Ser!ice 'te,t, 1./ c!aracters( Optional
2nit 'if applicable( 'te,t, 1./ c!aracters( Optional
Position 'if applicable( 'te,t, 1./ c!aracters( Optional
Scienti#ic Degree 'if applicable( 'te,t, 1./
c!aracters(
Optional
Summary o# Pro#essional e5perience 'te,t,
1".// c!aracters(
Please describe !our emplo!ment
e'perience -if applicable.
Optional
;. Personal S.ills and competences
Language S.ills
(ot%er Tongue (drop-do0n list) 'de*er9
conter uma lista)em de l:n)uas(
Compulsory
6t%er Languages: ';able to insert
information:
+ < possible options for lan)ua)es s6ills: 1asic
$ser, ,ndependent $ser, ro!icient $ser)
Optional
Languages
2nderstanding Spea.ing
<riting
Listening :eading
Spo.en
'nteraction
Spo.en
Production
=an)ua)e
1
=an)ua)e
3
=an)ua)e
<
Social and multi"cultural competencies
(text, 12000 characters)
Compulsory
Tec%nical and computer s.ills (text, 12000
characters)
Compulsory
=. Academic Ac%ie!ements > Pu$lications
Academic Ac%ie!ements
Please list and descri$e your main
academic ac%ie!ements and a-arded
pri?es 'te,t, 1"/// c!aracters(
Optional
Pu$lications
(n case !ou have alread! published a
scientific work or contributed to the
publication of an! paper please indicate
the most representative ones, ma'imum
ten, giving priorit! to those most related
with !our mobilit! proposal
/he references must include0 authors, title,
publisher, !ear, cit!, page number and
other relevant bibliographical data
(f !ou don)t have an! publication, click on
*+ave, without writing an! information
'te,t, 1."/// c!aracters(
Optional
@. Selection o# Academic 6##er
First %ost institution and academic o##er
priority 'Course Name- >ost institution-
Mobility $uration(
Compulsory
Second %ost institution and academic o##er
priority'Course Name- >ost institution-
Mobility $uration(
Optional
T%ird %ost institution and academic o##er
priority 'Course Name- >ost institution-
Mobility $uration(
Optional
A. (oti!ation Letter
<%y do you -ant to participate in t%is
programme3
<%at impact -ill t%e mo$ility proposal and
your participation -ill %a!e on your
pro#essional ac%ie!ements and %ome
country3
'te,t, 3".// c!aracters(
Compulsory
B. (o$ility Proposal
Please indicate t%e main aspects o# your
mo$ility proposal.
T%e mo$ility programme proposed must
co%erently descri$e t%e e5isting relation
$et-een t%e acti!ities you de!elop and
t%ose you intend to de!elop at t%e %ost
institution. T%is mo$ility programme -ill $e
used as a mean #or t%e %ost institution to
e!aluate t%e rele!ance and interest in its
implementation. T%e #inal mo$ility proposal
-ill $e, in case o# selection, articulated and
de#ined $y t%e sc%olars%ip %older, t%e
coordinating and t%e %ost institution and,
Compulsory
in speci#ic cases, t%e %ome institution.
(text, 32500 characters)
1C. Documents to 2pload +please c%ec.: %ttp://#ello-.unl.pt/inde5.p%p/master"p%d"post"p%d"tg1"2/