《DNL- Tops？e 博士生奖学金申请表》.doc

Appendix 1 Application Form of DNL- Topsøe Ph.D. Student Scholarship Programme Table 1 To be Completed by the Applicant Name： Gender： Date of Birth： Y M D Place of Birth： ID No.： Date of Ph.D. Enrollment： Y M Expected Completion Date: _______Y_______ M Office Phone： Fax: _______________ Mobile: ________________ Email： Institution Name： Institution Address: __________________________________________________________ Major： Topic of Ph.D. Thesis: ________________________________________________________ Signature of the Applicant： Date： ______ Y ______ M_______ D Educational Information Educational Experience： Working Experience： Summary of the Ph.D. work: (not more than three pages including the Ph.D.-student’s name, the thesis title, the Institution name, the thesis content, the investigation purpose, scientific novelty, received results, to be Attached Separately) Study Plan for one year: (including the Ph.D.-student’s name, thesis title, institution name) Publication List Self-Evaluation： Table 2 To be Completed by the Institute Name of Institute： Supervisor Name Institute Telephone E-mail Title or Position Recommendation of Supervisor： Signature of the Supervisor： Y M D Y M D Comments of the Division Head： Signature of the Division Head：