2nd Edition of the support program for PhD students - APPLICATION FORM | NWU

Personal details of the applicant

Title

Family name / Surname

Given name / First name

Birth date

Country of birth

Nationality

Marital status

Telephone number (mobile)

E-mail address

Institution/Business

Address

Street address

City/Town

ZIP/Postal Code

Country

Current job title

Educational background

Full name of institution and country

Degree obtained

Year obtained

PhD Registration at home institution

Name of institution where registered

Address of institution

City/Town

Country

Supervisor(s)

E-mail address of supervisor(s)

Topic of PhD research

Year of first registration for PhD

Which software programme do you use for statistical analysis?

Publications

List your significant publications or research projects of the last 5 years

Language ability

Please rate your English language proficiency from 1 (poor) to 3 (acceptable) to 5 (very good)

Questions	1	2	3	4	5
Spoken	1	2	3	4	5
Understanding	1	2	3	4	5
Written	1	2	3	4	5

First language

Other languages

Professional activities

Describe your current responsibilities and professional activities

Personal statement

Explain why you are applying for this PhD Support Program, what you hope to learn from it and how will it benefit your professional development

Applying for a grant: nationals from South Africa, Ghana, Botswana, Malawi and Kenya

Are you going to apply for funding (grant) from CEN-UG?

Type of grant

Tuition fee

Accommodation

Write a motivation why you should receive the grant

NO travel grants are available. Funds for travel must be confirmed when you apply for a position.

Funding available for travel (see official endorsement)

Applying for a grant: other Nationals

Are you going to apply for funding (grant) from CEN-UG?

Type of grant

Tuition fee

Accommodation

Write a motivation why you should receive the grant

NO travel grants are available. Funds for travel must be confirmed when you apply for a position.

Funding available for travel (see official endorsement)

Covid-19

Are you fully vaccinated for Covid-19?

Will you get vaccinated if you are selected?

Are you prepared to commit to all Covid-19 regulations of South Africa if you are selected at the time of the 6-day on-campus meeting?

Official endorsement

Please download and complete the Official Endorsement Letter and upload in the next file upload field.

Please upload Endorsement letter

Upload requirements

Additional information needed

Please upload a 2-page concept note of your research. Include where you are currently with the research process

Upload requirements

Explain why you chose this particular field of study

Letter of support from your supervisor to participate in the PhD Support Program

Upload requirements

Statement of applicant

I declare that the above information is true and correct. I undertake to complete the full PhD Support Program (the online modules as well as the 6-day on-campus meeting in Potchefstroom, South Africa) if I am selected to attend the Program.

Participant signature

Sign above