Application form Travel Grants 2014

Summary

Please fill out this form on a computer. The spaces can be adjusted according to need. Save the file as part of your travel grant application.

Family name and given name
Sex (man/woman)
Educational institution where you are enrolled
Faculty or department
Name of the training and current study programme (semester or year)
Study component to which the stay relates (e.g. thesis, placement)
Name of the Flemish promoter
Destination country and place
Expected stay duration (no less than one month within 2014) / Expected duration (months/weeks)
Departure date
Return date
Title of the assignment in the destination country
Name and type of receiving institution in the destination country (e.g. university, NGO, hospital)
Name of the local promoter

Student’s personal details

Nationality
Place and date of birth
Official address and phone number
Contact address (if different) and (mobile) phone number
Phone number of a third person in case of emergency
Bank account number
Student email address
Personal email address
Studies
Summarise your higher education studies, including certificates, grades and name of the educational institution.
Languages
List each language together with your standard (basic / average / excellent).
Relevant experience
State experience that is relevant to the assignment (e.g. voluntary work) and whether you have been to a developing country (if so as part of what?).
Where you, during last academic year, entitled to a study scholarship from the Flemish Government? (yes/no)[1]

Promoters’ details

Position and contact details of the Flemish promoter
Position and contact details of the local promoter

Assignment & results

What is the goal of your assignment in the selected country? (Distinguish between your goal with respect to your studies and the goal of the institution where you will work)
What results do you expect to achieve at the end of your stay? (Distinguish between your results with respect to your studies and the results for the institution where you will work)
What will you do to achieve those results? What does your role consist of exactly? Will you receive local or other support? Explain.

Development relevance

Why and how did you select the destination and the assignment?
Point out how your field of study can establish an added value for a certain necessity of the country of your destination.
Describe the organisation where you will conduct the assignment. State whether your assignment is part of another VLIR-UOS programme[2] or another partnership (NGO, …) and provide some extra information about this partnership.
How will the local institution utilise these results to contribute to the development of the place or region?

Preparations

Does your work build on the work of other students or researchers? Explain.
What does the local promoter expect from you in terms of assignment preparation?
How will your Flemish promoter support your assignment?
How have you prepared for your stay in the South and what further preparations will you make?
Please note that you must have to take part in the Intercultural Preparation Day, and the Information Session on Safety and Health. Consult the KU Leuven travel grants website for more information. If you have already taken part in these days, please let us know.
In what language will you conduct your assignment? Do the persons you will come into contact with speak this language? Do you have knowledge of specialist terminology in this language?
How safe do you feel the region you are going to is? (See among other things the foreign affairs department recommendations at www.diplomatie.be)

The stay

How is your stay planned? Provide a schedule for the whole period showing the assignment is feasible. Which tasks will be conducted during which period of your stay?
What have you agreed and what do you intend to agree with your local promoter about your stay? (E.g. housing, transport, assistance in situ and possible related costs)
Where applicable, provide the names of other Flemish students you know – perhaps in another field of study or from another institution – that will be active at the same local organisation at the same time.

The return

What do you plan to do with your experience when you return to Belgium? How will you share that experience with others?

The finances

Expected costs
Provide an estimate of the following costs / Ticket
Visa
Travel insurance
Other (medical costs, overnight costs, …)

Final Stipulations

I accept that the higher education institution from which I am applying for a travel scholarship or VLIR-UOS can pass on my name and email address to current or future travel scholarship students that are interested in the same destination, as a source of practical information.

I confirm that I shall purchase a travel insurance that is valid in the destination country for the duration of my stay. Minimally, this insurance should cover annulation, third party liability, accidents illness and repatriation.

I confirm that I shall follow the medicine and vaccination recommendations for my destination of the Institute of Tropical Medicine Antwerp (www.itg.be).

I confirm that I shall follow the travel advice for my destination of the Federal Public Service Foreign Affairs, Foreign Trade and Development Cooperation (www.diplomatie.be).

I accept that neither the higher education institution from which I am applying for a travel scholarship nor VLIR-UOS is responsible for any situation that causes damage to myself or third parties or for any damage during my stay in the South.

I have never received a travel scholarship of VLIR-UOS before and that the information of my application is correct.

I confirm that I will submit the online travel report of VLIR-UOS before at least one month after my return.

I confirm I have read and understand the eligibility criteria for a Travel Grant of VLIR-UOS. If I am selected for a travel grant, I understand I can appeal to the travel grant if I my actual stay doesn’t violate the eligibility criteria (example: shorter stay, no submission of the online travel report).

I agree following people will read my online registration and online travel report:

·  The people of my higher education institution and association whom are responsible for the travel grant programme. It is possible these people will contact my Flemish and/or local promotor to enlighten certain aspects of the report/registration.

·  Interesting cases will be selected, summarized and examined by people responsible for the travel grant programme of other institutions.

·  VLIR-UOS will summarize and analyze the reports in order to improve the VLIR-UOS travel grant programme.

·  My travel report can be used to promote the VLIR-UOS travel programme and/or inform other students.

Signature: Place and date:

Annexes

·  A motivation letter in which you, in a free format on 1 page, write down your personal motivation, reasons to carry out this project and possibly relevant experience.

·  A signed letter of recommendation or email from the Flemish promoter (no more than 2 pages in Dutch, English or French) in which the promoter confirms his/her support for the candidate and approves the assignment. The promoter may also provide additional information on the assignment context (e.g. contacts with the local institutions, organisations or partners, the project’s cooperation context). No more than 2 pages in Dutch, English or French.

·  A signed letter of invitation or email from the local promoter in which the promoter confirms his/her support for the candidate and approves the assignment. The promoter may also provide additional information on the assignment context. No more than 2 pages in Dutch, English or French. If the local promoter writes the letter of invitations in any other language (for example Spanish), the student will provide a translation.

Application form Travel Grants 2014 for students at a Flemish higher education institution / 5/8

[1] We can carry out random controls at the central administrations of the different institutions

[2] Ask your Flemish promoter to find out whether your assignment is part of a VLIR-UOS partnership.