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)................................................................................................