Graduate Academy:

I would like to apply for a grant for completion of doctoral dissertations.

Fields marked with * must be filled in.

Personal and dissertation data

Salutation*:

Academic Grade:

First Name:*

Last Name:*

Street*:

Postal Code*:

City*:

Phone*:

E-Mail*:

Mobile Phone:

Place of Birth*:

Date of Birth (dd/mm/yyyy)*:

Gender*:

Citizenship*:

Status*:

Faculty, Institute*:

Starting date of your doctoral training (dd/mm/yyyy)*:

Topic of your dissertation*:

Name of doctoral supervisor*:

Planned submission date for your dissertation
to the faculty (dd/mm/yyyy)*:

Desired duration of the grant from (dd/mm/yyyy)*:

Desired duration of the grant to (dd/mm/yyyy)*:

Duration of the grant (Up to 5 Month)*:

Desired monthly grant amount (€)*:

Previous funding

Duration from (dd/mm/yyyy)*:

Duration to (dd/mm/yyyy)*:

Type of funding:

Amount monthly (€)*:

Additional funding expected during the desired dissertation grant period

Duration from (dd/mm/yyyy)*:

Duration to (dd/mm/yyyy)*:

Type of funding:

Amount monthly (€)*: