FELLOWSHIP
Application form

Berlin Third Joint School on “Comparative Urban Studies”, August 17-September 3 2013

Deadline for applications: February 24th, 2013

Personal Information                        e-mail:……....…………………………………..….	
Family Name:	...………………………………...	Name:	……………………………...	
Date of Birth (ddmmyyyy):	…………….	Place of Birth:	…….………….	Your picture
(mandatory)	
Gender:	Male □	Female □	Nationality:	…………………..		
Corresponding Address:	……………………………………………………………		
City:	…………...	Zip:	…………	Country:	…………………..		
Educational Information	
Are you enrolled in a PhD programme	Yes□	No□	In which discipline?	………………….	
Where?	……………………………	Who is your supervisor?	……………………………	
Has Your Paper been accepted?	
Title of the paper:	……………………………………………………………………………….	
In which session?	………………..………	Session’s convener:	…………………..	
				
Eligibility Criteria Check 	
			Yes	No	
1) Are you from a Country classified under “B” or “C” category by ISA?			
2) Has your paper been accepted at the conference?			
3) Have you attached two recommendation letters?			

Place, date_______________________	Signature _______________________	

IMPORTANT: Please send this form duly filled in as well as the , to: yuri.kazepov@uniurb.it