Department of Bioanalyse – Laboratory of Food Analysis

Application form of the STI(Short Training Initiative):

“ INTENSIVE TRAINING ON MYCOTOXIN ANALYSIS ”

August 28 – September 10, 2014

Promotor:Prof. Dr. Apr. Sarah De Saeger ()

Please complete this form in English

1. The Applicant

Surname(s)
First Name(s)
Place of birth
Date of birth
Nationality
Gender
Civil status (married, single, …)
Children (number)
Passport number
Home address (Domicile address)
Current place of residence
Affiliation (address work place)
Home telephone
Work telephone
E-mail

2. Studies

University degrees (including bachelor and master’s programmes). Diplomas and/or current studies (note all years of study and major fields of study, with complete and precise designations and details, etc.) / Deliberation date (day, month, year) / University or jury + country

3. Professional experience

Please mention all jobs you have done since your graduation or which are relevant for this course (mention period of employment,name employer, academic/industry/government, function and main duties and gained skills).

4. Projects

Please mention all relevant projects you been involved in (mention period, project name, project type, funding agency, specific role in the project).

5. Post-graduation courses

Please mention all relevantpost-graduation courses you followed (mention period, name course, organizer, location).

6. Stays abroad

If you did part of your studies abroad (outside your homeland) or stayed abroad in function of your work, you can specify it here.

7. Congresses and workshops

Please mention all relevant congresses and workshops you have participated (mention the name of the congress or workshop, contribution (oral or poster), date, organizer and location).

8. Scientific awards and distinctions

If you have received any scientific awards or distinctions, please mention here when and for which achievement they have been awarded.

9. Scientific publications of the applicant

List of publications of the candidate, mentioning all authors and full reference of each publication. Order the publications chronologically, number them and indicate those articles for which the applicant is the first author in bold. Only mention publications that are published, in press or accepted for publication. To give equal opportunities to all candidates, no bibliographic updates will be accepted after the deadline.

10. Motivation for participation

Explain why you want to participate in this training. Why do you think you are the suitable candidate. What experience do you think to gain from this training. What professional/scientific plans do you have for the future and what will be the benefit of this training course for these plans. ….Max. one A4

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Faculteit Farmaceutische Wetenschappen

Vakgroep Bioanalyse – Laboratorium voor Bromatologie – partner in

Harelbekestraat 72, B-9000 Gent