Family Representative

European University Viadrina

Family representative

Große Scharrnstr. 59

15230 Frankfurt (Oder)

Bridging scholarships for doctoral students and postdoctoral fellows with family responsibilities (support lines A and B)

Application form

Applicant

First names: / Surname:
Enrolment number: / Date of birth:
Street, House number: / Zip code: / City:
Telephone: / E-Mail:
Account holder: / Bank:
IBAN: / BIC:
Desired scholarship period:
(max. 6 months from january to
december 2017)

Details of planned qualification

Faculty: / Main supervisor of the planned qualification:
Begin of the planned qualification: / Likely completion of the planned qualification:
If relevant, membership of a doctoral or graduate college:
Title of the of planned qualification:
In which way will the scholarship help you to recommence, continue or complete the planned qualification?

Family details

Name of the child(ren) / Date of birth of the child(ren)
1
2
3
I am a single parent / Yes / No
What is your family situation? Please concentrate on the family reasons for any extension of your doctoral studies or for your family time out. Please give details of particular difficulties (financial, social hardship etc.). If you need more space you can attach a declaration as an appendix.
Details of your financial situation (please provide suitable proof with your application)
Scholarship
Will you receive a scholarship or similar support from another source during the period of support? / Yes / No
If yes, how much (Euro/Month):
Own income during the scholarship period:
From scientific activities (Euro/Month):
From non-scientific activities (Euro/Month):
Please also provide the following documents:
Résumé
Exposé of the planned qualification (incl. time schedule, table of contents and publications list)
Written confirmation of a university teacher that the applicant has a scientific connection to
Viadrina
A written assessment from the supervisor (evaluation of the academic performance of the applicant, assessment of the effect of the scholarship on the success of the planned qualification)
Proof of a completed university degree and, if applicable, completed doctorate
Suitable proof of personal income during the scholarship period (pay slips, grants). You can use your tax statement from the previous year as proof of income. If this does not correspond to your current income please provide proof of current income

If relevant, the birth certificate of the child and, in the case of adoptive children/stepchildren etc.

proof of residency in your household (e.g. proof from the responsible Residents Registration

Office ).

If relevant, proof of the level of care or the care needs of the relative.

I hereby declare that the information I have provided is correct and undertake to promptly provide written proof of any changes to the information above.

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