Application form NanoforumEULA
1. |
Name and work address of candidate |
Name |
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Function |
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Organisation |
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Department |
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Address |
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Postcode, Town |
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Country |
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Telephone |
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Fax |
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Website |
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2. |
C.V. of the candidate [maximum 2 pages A4] |
2.1. |
Working experience |
2.1.1. Nanotechnology working experience
2.2. |
Education |
2.2.1. |
Nanotechnology education |
2.3. |
Recent publications relevant to nanotechnology |
3. |
Profile of the employing organisation [maximum 2 pages A4] |
3.1. |
Research activities |
3.1.1. |
Nanotechnology research activities |
3.2. |
Research infrastructure and equipment |
3.3. |
Future research strategies in nanotechnologies |
3.4. |
Collaboration partners in Europe |
3.4.1. |
Existing partners |
3.4.2. |
Interest in NANOFORUMEULA partners |
Organisation (select one) |
Research areas, type of collaboration sought |
UT, MESA+ MINATEC Fraunhofer IWS UAM |
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4. |
Employer’s declaration |
The legal representative of the candidate’s employing organisation must fill in, sign and stamp the declaration below. Without this declaration, the application will not be considered for funding.
Name |
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Function |
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Address |
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Post code and Town |
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Country |
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Telephone |
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Fax |
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Website |
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Place:
Date:
To whom it may concern,
I herewith declare the willingness of my organisation……………………………………….. to pay the salary of candidate ……………………………………………………………….......
who has applied for a NanoforumEULA visit grant, during his/her visit to Europe. My organisation herewith expresses interest in establishing longer term collaboration with the European host organisation……………………………………………………………………...
Signature:
Stamp or seal of organisation:
5. |
Detailed research plan [maximum 5 pages A4] |
The candidate must propose a detailed plan for carrying out up to three months research of excellent scientific quality in one of the European centres in nanotechnologies which are partners in NANOFORUMEULA. The proposal must include arguments for the relevance of the proposed research to the host organisation.
6. |
Scientific quality of the proposal [maximum 1 page A4] |
The candidate must include evidence of the scientific quality of his or her proposal which is convincing to a selection committee of scientific peers.
7. |
Relevance for socio-economic development of Latin America [max. 1 page A4] |
The candidate must include arguments for the relevance of his or her research project for the socio-economic development of his country or Latin America in general.
8. |
Dissemination and publication plan [maximum 1 page A4] |
After the visit, the candidate must not only publish results of his research in scientific media, but also communicate about it to the general public, making it clear that he or she has benefited from funding by the European Commission. This can be by giving a lecture for a lay audience, presenting results to local companies, giving interviews to national or local media or publishing an opinion article in a newspaper or public magazine. Ineke Malsch will interview all visitors and publish these interviews in English online. The visitor is required to translate the interview in his or her national language, send it as press release to local or national media in his or her home country and send the press release in his or her national language as well as evidence of other dissemination activities to Ineke Malsch.
List of eligible countries in Latin America
Latin America |
Caribbean |
Argentina |
Barbados |
Bolivia |
Belize |
Brazil |
Cuba |
Chile |
Dominica |
Colombia |
Dominican Republic |
Costa Rica |
Grenada |
Ecuador |
Guyana |
El Salvador |
Haiti |
Guatemala |
Jamaica |
Honduras |
Saint Kitts and Nevis |
Mexico |
Saint Lucia |
Nicaragua |
Saint Vincent and Grenadines |
Panama |
Suriname |
Paraguay |
Trinidad and Tobago |
Peru |
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Uruguay |
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Venezuela |
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