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APPLICATION FORM

Soil and Water Relationship(SWR 2013)

EU Summer School organised by:

Czech University of Life Sciences Prague

Faculty of Agrobiology, Food and Natural Resources(FAFNR)

Department of Water Resources (DWR), Professor SvatMatula

Kamycka 129, 165 21Prague 6, Czech Republic, EU,

Phone: +420224384636 / +420224382572,Fax: +420234381835,

and

Ondokuz Mayıs University (OMÜ) in Samsun,

Faculty of Agriculture,Department of Soil Science, Professor Coşkun GÜLSERand International Relations Office of OMÜ,

55139 Kurupelit-Samsun, Turkey
Phone: +90-362-3121919 (Ext.7222), Fax: +90-362-4576091,

Date and Place: From3rd June to 18th June, 2013 in Samsun University Campus

Prerequisites: Study fields (MSc, or PhD):Natural Resources/Water Sciences

/Water Management/Soil Sciences

Support: e-learningfrom 15thMay to1stJune

Credits:6 ECTS

Number of participants:maximum 20 selected students, first-in, first-served

Instruction language:English

Student´s share in the costs of SWR2013: 155TRY (or 65EUR) + accommodation in OMÜ campus (price for students)and transport to/from Samsun. NO fee, excursion is included in the share of costs.
Please complete and send this form:
  1. Electronically, filled and scanned version with the signaturetoMrs.Dr. M. Mihalikova, , CULS, FAFNR, Dept. of Water Resources
  2. Electronically, copy of previous forms to:International Relations Office (IRO) of Ondokuz Mayıs University in Samsun, Mrs. Emine Bol Yazici, /
Application deadline:Friday 15thMay,2013, 4:00p.m.
Detailed information about the school will be given to accepted participants via e-mail

Personal data

Family name:
First name(s): / Male: / Female:
Date of birth:
(date/month/year) / Nationality:
Name of home university:
Name and address of academic contact Erasmus / IRO person at home university:
Current address
Street and No.:
Telephone No.: / Mobile phone: / E-mail:
Postal code and city: / Country:

Academic profile

Degree presently studied:

MSc PhD / Major field(s) of study:

Month and year of enrolment:

/

Student registration number:

Language proficiency in English:
Indicate level: Moderate Good Excellent

Alternative/Parents address (in case of personal difficulties during stay in Samsun, June2013)

Name: / Relationship:
Street and No.:
Postal code and city: / Country:
Telephone No. (incl. international prefix): (private/work) / Mobil phone: / E-mail:
MOTIVATION
Write here, please, motivation for participating in the intensive summer school. Describe shortly your present studies and academic background:
Signature of applicant
I wish to apply for the intensive SWR 2013 at the Ondokuz Mayıs University in Samsun.
I hereby confirm that the above information is correct.
Date: / Signature:

NOT filled by the applicant

Signature of Director of the Course, Prof. Dr. SvatMatula from CULS, FAFNR, DWR
I hereby confirm the acceptance of the student for participation in the summer school.
Date: / Acceptance:
Yes No / Signature:
Number acceptance:

Department of Water Resources, FAFNR, CULS Prague, Czech Republic, European Union