Application form Wageningen Talent Programme 2017

1. Proposal title

2. Details of applicant

- Title:

- First name:

- Initials:

- Prefix:

- Surname:

- Male/female:

- Address for correspondence:

- Telephone:

- Email:

- Private email (optional):

- Website (optional):

3. Graduate School
Indicate the graduate school you will apply to. Competition will take place between applicants within one graduate school.

EPS/PE&RC/VLAG/WASS/WIAS/WIMEK

4. Curriculum vitae applicant (max 3 pages, publication list excluded):

4a. Personal details

Title(s), initial(s), first names (in full), surname:

Nationality:

Date of Birth:

4b. Master's degree

University/College of Higher Education:

Faculty:

Date of the certificate:

Main subject:

4c. Doctorate

University/College of Higher Education:

Date and place that the doctoral degree was obtained as stated on your certificate:

Principle Supervisor:

Title of thesis:

4d. Current employment and work experience since graduation

4e. Brief summary of pre- and/or postdoctoral research experience
(max. 300 words)

4f. International activities (research and study) indicating the duration per activity

4g. Scholarships and prizes

4h. Other academic activities

4i. List of Publications

5. The Proposal

5a. Summary of the proposal (max. 250 words)

5b. Description of the proposed activities(4 pages maximum, including figures, excluding literature references)

Include details of objectives, innovative aspects, scientific approach, impact, institutional collaboration and literature references

5c. Value of the proposal to your career

5d. Value of the proposed collaboration for the affiliated foreign research group and Wageningen Universityi.e., will the proposed research strengthen collaboration between institutes.

5c. 5 most relevant publications of the Wageningen research group and thecollaborating partner related to the proposed activities

1.

2.

3.

4.

5.

6. Composition of the research group

List all staff members involved in the proposed activities: provide name, initials, titles and type of involvement, e.g. daily guidance, technician, thesis supervisor, advisor.

Name and titleSpecialisationInstitutionInvolvement

7. Timetable of the activities

8.Scientific embedding of the proposed activities(max. 250 words)

Affiliation with national and international research programmes, national and international collaborations

10. Budget

Financial assistance from other sources:

Is the financial support and equipment sufficient to carry out the research?

11. Societal relevance

12. Legal requirements

Has been complied with the law and legal requirements with respect to the proposed activities, such as ‘DNA-recombinant legislation’, ‘Code Openness Animal Experiments’, and/or ‘Code of conduct on Biosecurity’ (if applicable)?

Ο YesΟ No

By submitting this document I declare that I satisfy the nationally and internationally accepted standards for scientific conduct as stated in the Netherlands Code of Conduct for Scientific Practice 2012 (Association of Universities in the Netherlands (VSNU)).

Ο YesΟ No

Details applicant:

Name:

Place:

Date:

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