Avenue E. Mounier, 83 | B-1200 Brussels | Belgium
+32 2 537 31 06 +32 2 539 03 74 fax /
Curriculum Vitae Application Form
Name / Title / First Name / Last NamePersonal data / Birthdate / Nationality / Membership ID number
Tel / E-mail / Address
Which fellowship are you applying for? / Research Fellowship (2.000 EUR) / Standard Fellowship (2.000 EUR)
I am interested in the Standard Fellowship if my application is not accepted for the research fellowship
Institute you wish to visit / Name / Department
Contact Person / E-mail
Degree subject/
Professional Qualification (s)/
Institution where awarded.
Present and Previous Positions Held (include dates to and from)
Relevant Publications
(Maximum 10)
Presentations to learned societies (maximum 10)
Research Grants on which the applicant was listed as a co-applicant (date, co-applicant, title, amount and funding body).
(Maximum of 10)
Supporting documents / Motivation letter describing area of interest, research plan and reason behind the visit.
The motivation letter should outline what the applicant expects to achieve during his/her visit. It should therefore detail what specific experience is sought and how this would fit into the applicant’s individual career development. In particular, details should be supplied regarding the Institution to be visited as well as the research opportunities the hosting department can offer. / Supporting letter from own Head of Department
Invitation letter from the Head of the Department you wish to visit indicating that the hosting unit is willing and able to provide the expected training experience AND confirming that the post will not be salaried. / A proposed budget sheet estimating how the funds will be spent (estimated cost of flights, accommodation, living expenses etc)
Date
Signature
Please send back your application form duly completed and all supporting documents in a single PDF document to the ESSO Secretariat, attention of Ana Galan, by fax (+32 2 539 03 74) or via e-mail () before the deadline of 31st October 2016.