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ACE Maritime UniversityUnder the auspices of the
Russian Geographical Society
APPLICATION FORMTo be returned to [email protected] by 27 May 2016 (17:00 CET)
(please do not change the format of this document)
A) Personal details
First name
Last name
Gender
Date of birth
Country of citizenship
Passport number
Visa requirement for Germany or South Africa (Yes/No)
Details of health insurance/ coverage (compulsory)
Medical condition/dietary requirements (if any)
Name of contact person in case of any emergency
AddressEmail
Telephone number
Mobile phone
B) Correspondence address
Street
Zip code and City
Country of residence
Mobile phone
C) Academic details
Highest qualification achieved
Name and website of awarding institution
Name of current institution and department
Current year of study
Target degree
Subject area
Title of degree thesis/PhD (if applicable)
Supervisor of current degree thesis/PhD (if applicable)
Email address of supervisor
Preferred theme (more than one may be selected)
Physical Oceanography Biological Oceanography Biogeochemistry and the Carbon Cycle Atmospheric Science Marine Instrumentation Data Management and Analysis Other ...
D) Previous sea-going experience
E) Next planned career step and motivation - please also explain how you would particularly benefit from this course (max 250 words)
F) Current research project/potential need for collection of water samples (if applicable)
Annex: Please prepare one PDF document containing the following sections:
1: 1-page Curriculum Vitae2: Proof of registration at current university3: Letter of recommendation from first bachelor/master supervisor or other lecturer who knows you well 4: Copy of valid passport5: Proof of health insurance/medical coverage
