University of Bergen

The Faculty of Mathematics and Natural Science

 

Application for ADMISSION to the ph.d.-Programme

 

1. Personal information:

 

Date of birth:

 

Personal number:

Surname:

Name:

 

 

 

 

Male        Female

 

Nationality:

 

             

 

 

 

 

 

 

 

Address:

 

 

Postal code and place:

Country (if outside Norway):

 

 

 

 

Telephone:

 

Private:

Work:

Telefax work:

 

E-mail:

 

 

 

 

 

 

2. Education:

Certified copies of certificates/diplomas, abstract of thesis and reading list must be enclosed.

 

A. Cand.scient.-degree or corresponding

Degree:

Year:

Term:

Main subject (see list 1 in the guidelines):

 

 

 

Code:

Name of main subject:

 

 

 

 

 

Institution:

 

Faculty:

Department:

 

 

 

 

 

Notes:

 

 

 

 

 

 

 

 

 

B. Other education

Education:

 

Year:

Term:

 

 

 

 

 

 

 

 

 

 

 

 

 

Instituton:

 

Faculty:

Department:

 

 

 

 

 

Notes:

 

 

 

 

 

 

 

 

Mark level – include only courses taken at UoB

“Emnegruppe” (60 credits) + “Studieretningsgruppe” (30 credits) or
Specialization (90 credits):

Institution:

Subject code:

Credits:

Mark:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Average mark:

 

Hovedfagsgruppe” (30 credits) or Master courses (60 credits):

Institution:

Subject code:

Credits:

Mark:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Average mark:

 

Mark on thesis:

 

 

 

3. Work experience after cand.scient.-degree or corresponding education:

 

 

 

 

 

 

 

 

 

 

 

 

4. Publications:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5. Information about the doctoral study:

Short description (max. 1 typewritten page) of the project must be enclosed.

 

Start date:

Expected finishing date:

Percentage of fulltime (see guidelines):

 

 

 

 

Place in charge (see guidelines):

 

 

 

Institution:

 

Faculty:

Department:

 

Working title:

 

 

 

 

 

 

 

 

 

 

Field of study (see list 2 in the guidelines):

Discipline number:                Discipline name:

 

 

 

 

 

Notes:

 

 

 

 

 

 

 

 

6. Conditions of employment and funding:

Admission contract must be enclosed (or forwarded)

 

Employer (see guidelines):

 

 

 

 

 

 

 

Type of employment:

 

 

 

Scholarship

Temporarily employed         Employed        

                                                               Work not connected to the dr.scient.-studies

 

 

 

 

 

 

Workplace:

 

 

 

Institution:

 

Faculty:

Department:

Section:

 

 

 

 

If external institution:

Does your department have a cooperation agreement with the institution?        Yes         No

If yes:     From date:                     Till date:

 

 

 

Main funding:

 

 

 

 

 

 

 

If The research council of Norway is the main funding, state area (se guidelines):

 

 

 

 

Funding pr. year:

 

 

 

Amount:

 

 

 

 

Source(s):

 

 

Prospective other funding sources:

 

 

 

Amount:

 

 

 

 

Source(s):

 

 

7. Academic supervision (To be filled in by supervisor(s)):

 

a. Principal supervisor:

 

Date of birth:

 

Personal number:

Surname:

Name:

 

 

 

 

Male      Female

Citizenship:

Degree/title:

 

           

 

 

 

 

 

 

 

Address (work)

 

 

Postal code and place:

Country (if outside Norway):

 

 

 

 

Phone no.:

 

 

Telefax work:

 

 

E-mail:

 

 

 

 

Supervisor from (date):

                 Till (date):

 

 

 

 

 

 

 

b. Co-supervisor(s):

Date of birth:

 

Personal number:

Surname:

Name:

 

 

 

 

Male      Female

Citizenship:

Degree/title:

 

           

 

 

 

 

 

 

 

Address (work)

 

 

Postal code and place:

Country (if outside Norway):

 

 

 

 

Phone no.:

 

 

Telefax work:

 

 

E-mail:

 

 

 

 

Supervisor from (date):

                 Till (date):

 

 

 

 

 

 

 

Date of birth:

 

Personal number:

Surname:

Name:

 

 

 

 

Male      Female

Citizenship:

Degree/title:

 

           

 

 

 

 

 

 

 

Address (work)

 

 

Postal code and place:

Country (if outside Norway):

 

 

 

 

Phone no.:

 

 

Telefax work:

 

 

E-mail:

 

 

 

 

Supervisor from (date):

                 Till (date):

 

 

 

 

 

 

 

 

8. Plan of study (please see the guidelines)

 

 

I. Formal part

 

Institution:

Subject code

Subject name:

ECTS credits:

Form of evaluation:

Exam

Term - year:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Special reading list

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

II. Knowledge transmission

 

Activity:

 

Place:

 

ECTS

credits:

Term - year:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


9. Signatures

 

 

.......................................................................................................................................................

Place                                      Date                                       Applicant’s signature

 

 

.......................................................................................................................................................

Place                                      Date                                       Supervisor’s signature

 

 

10. Prospective comments from scientific supervisor:

 

 

 

 

 

11. Signature from leader of external institution

(To be filled in only if the applicant’s work place is an external institution outside The Faculty of Mathematics and Natural Sciences)

 

 

.......................................................................................................................................................

Place                                      Date                                              Leader of external institution’s signature

 

 

12. Comments and recommendations from the department’s doctoral committee:

(If the applicant’s work place is an external institution outside The Faculty of Mathematics and Natural Sciences comments/recommendations should be made by the PhD committee at the administrating department at The Faculty of Mathematics and Natural Sciences. )

 

 

 

.......................................................................................................................................................

Place                      Date                                       Leader of the department’s doctoral committee

 

 

13. Enclosures:

 

 Certificates with transcripts

 Abstract of thesis

 Reading list

 Project description (max. 1 typewritten page)

 Admission contract

 Other (specify)................................................................................................