1. Personal Data
Last Name:
Please fill in your personal data.
First Name:
Middle Name(s):
Gender: male female
Date of Birth : . .
Date must be given as "day.month.year" (dd.mm.yyyy).
City of Birth:
Please select "Country of birth" and "Nationality" (name of country) from the pull down menu. If your country is not listed, select "Other" and specify it in the text field on the right.
Country of Birth: Algeria Argentina Armenia Australia Austria Azerbaijan Bangladesh Belarus Belgium Belize Bolivia Brasil Bulgaria Burundi Cameroon Canada Chile Colombia Costa Rica Croatia Cyprus Czech Republic Dominican Republic Ecuador Egypt Eritrea Estonia Ethiopia Finland France Germany Ghana Greece Guatemala Honduras Hungary India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kenya Kuba Kuwait Kyrghyzstan Laos Latvia Lebanon Lesotho Lithuania Luxemburg Malawi Malaysia Mexico Moldova Morocco Myanmar Namibia Nepal Netherlands Nicaragua Nigeria North Korea Norway Oman P.R. China Pakistan Panama Papua New Guinea Peru Philippines Poland Portugal Romania Russian Federation Saudi Arabia Scotland Singapore Slovenia South Africa South Korea Spain Sudan Swaziland Sweden Switzerland Syria Taiwan Tanzania Thailand Tunisia Turkey Uganda Ukraine United Arabian Emirates United Kingdom USA Venezuela Vietnam Yemen Yugoslavia Zimbabwe Other (specified right)
Nationality: Algeria Argentina Armenia Australia Austria Azerbaijan Bangladesh Belarus Belgium Belize Bolivia Brasil Bulgaria Burundi Cameroon Canada Chile Colombia Costa Rica Croatia Cyprus Czech Republic Dominican Republic Ecuador Egypt Eritrea Estonia Ethiopia Finland France Germany Ghana Greece Guatemala Honduras Hungary India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kenya Kuba Kuwait Kyrghyzstan Laos Latvia Lebanon Lesotho Lithuania Luxemburg Malawi Malaysia Mexico Moldova Morocco Myanmar Namibia Nepal Netherlands Nicaragua Nigeria North Korea Norway Oman P.R. China Pakistan Panama Papua New Guinea Peru Philippines Poland Portugal Romania Russian Federation Saudi Arabia Scotland Singapore Slovenia South Africa South Korea Spain Sudan Swaziland Sweden Switzerland Syria Taiwan Tanzania Thailand Tunisia Turkey Uganda Ukraine United Arabian Emirates United Kingdom USA Venezuela Vietnam Yemen Yugoslavia Zimbabwe Other (specified right)
Marital Status: single married
Your e-mail address must be valid and reachable during registration process or online application will fail.
No. of Children:
E-Mail Address:
2. Address
Current Address
Street:
Please indicate the address to be used for correspondence DURING the application and admission process.
Postal Zip Code:
City:
State:
If applicable
Country: Algeria Argentina Armenia Australia Austria Azerbaijan Bangladesh Belarus Belgium Belize Bolivia Brasil Bulgaria Burundi Cameroon Canada Chile Colombia Costa Rica Croatia Cyprus Czech Republic Dominican Republic Ecuador Egypt Eritrea Estonia Ethiopia Finland France Germany Ghana Greece Guatemala Honduras Hungary India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kenya Kuba Kuwait Kyrghyzstan Laos Latvia Lebanon Lesotho Lithuania Luxemburg Malawi Malaysia Mexico Moldova Morocco Myanmar Namibia Nepal Netherlands Nicaragua Nigeria North Korea Norway Oman P.R. China Pakistan Panama Papua New Guinea Peru Philippines Poland Portugal Romania Russian Federation Saudi Arabia Scotland Singapore Slovenia South Africa South Korea Spain Sudan Swaziland Sweden Switzerland Syria Taiwan Tanzania Thailand Tunisia Turkey Uganda Ukraine United Arabian Emirates United Kingdom USA Venezuela Vietnam Yemen Yugoslavia Zimbabwe Other (specified right)
Please select "Country" from the pull down menu. If your country is not listed, select "Other" and specify it in the text field on the right.
Phone Number:
Fax Number:
If applicable
Permanent Personal Address (if different from your current address)
Street:
Please indicate the address to be used for correspondence AFTER the application and admission process, e.g. home address, address of parents or relatives.
Postal Zip Code:
City:
State:
If applicable
Country: Algeria Argentina Armenia Australia Austria Azerbaijan Bangladesh Belarus Belgium Belize Bolivia Brasil Bulgaria Burundi Cameroon Canada Chile Colombia Costa Rica Croatia Cyprus Czech Republic Dominican Republic Ecuador Egypt Eritrea Estonia Ethiopia Finland France Germany Ghana Greece Guatemala Honduras Hungary India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kenya Kuba Kuwait Kyrghyzstan Laos Latvia Lebanon Lesotho Lithuania Luxemburg Malawi Malaysia Mexico Moldova Morocco Myanmar Namibia Nepal Netherlands Nicaragua Nigeria North Korea Norway Oman P.R. China Pakistan Panama Papua New Guinea Peru Philippines Poland Portugal Romania Russian Federation Saudi Arabia Scotland Singapore Slovenia South Africa South Korea Spain Sudan Swaziland Sweden Switzerland Syria Taiwan Tanzania Thailand Tunisia Turkey Uganda Ukraine United Arabian Emirates United Kingdom USA Venezuela Vietnam Yemen Yugoslavia Zimbabwe Other (specified right)
Please select "Country" from the pull down menu. If your country is not listed, select "Other" and specify it in the text field on the right.
Phone Number:
Fax Number:
If applicable
Last affiliation (optional)
Institution:
Please indicate the address of your last affiliation (if applicable).
Department:
Street:
Postal Zip Code:
City:
State:
If applicable
Country: Algeria Argentina Armenia Australia Austria Azerbaijan Bangladesh Belarus Belgium Belize Bolivia Brasil Bulgaria Burundi Cameroon Canada Chile Colombia Costa Rica Croatia Cyprus Czech Republic Dominican Republic Ecuador Egypt Eritrea Estonia Ethiopia Finland France Germany Ghana Greece Guatemala Honduras Hungary India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kenya Kuba Kuwait Kyrghyzstan Laos Latvia Lebanon Lesotho Lithuania Luxemburg Malawi Malaysia Mexico Moldova Morocco Myanmar Namibia Nepal Netherlands Nicaragua Nigeria North Korea Norway Oman P.R. China Pakistan Panama Papua New Guinea Peru Philippines Poland Portugal Romania Russian Federation Saudi Arabia Scotland Singapore Slovenia South Africa South Korea Spain Sudan Swaziland Sweden Switzerland Syria Taiwan Tanzania Thailand Tunisia Turkey Uganda Ukraine United Arabian Emirates United Kingdom USA Venezuela Vietnam Yemen Yugoslavia Zimbabwe Other (specified right)
Please select "Country" from the pull down menu. If your country is not listed, select "Other" and specify it in the text field on the right.
Phone Number:
Fax Number:
If applicable
3. Education
a. Second Degree (e.g. MSc, Diplom)
College or University:
Please list the enrollment leading to your second degree (e.g. MSc/Diplom; affiliated College/University).
City:
State:
If applicable
Country: Algeria Argentina Armenia Australia Austria Azerbaijan Bangladesh Belarus Belgium Belize Bolivia Brasil Bulgaria Burundi Cameroon Canada Chile Colombia Costa Rica Croatia Cyprus Czech Republic Dominican Republic Ecuador Egypt Eritrea Estonia Ethiopia Finland France Germany Ghana Greece Guatemala Honduras Hungary India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kenya Kuba Kuwait Kyrghyzstan Laos Latvia Lebanon Lesotho Lithuania Luxemburg Malawi Malaysia Mexico Moldova Morocco Myanmar Namibia Nepal Netherlands Nicaragua Nigeria North Korea Norway Oman P.R. China Pakistan Panama Papua New Guinea Peru Philippines Poland Portugal Romania Russian Federation Saudi Arabia Scotland Singapore Slovenia South Africa South Korea Spain Sudan Swaziland Sweden Switzerland Syria Taiwan Tanzania Thailand Tunisia Turkey Uganda Ukraine United Arabian Emirates United Kingdom USA Venezuela Vietnam Yemen Yugoslavia Zimbabwe Other (specified right)
Please select "Country" from the pull down menu. If your country is not listed, select "Other" and specify it in the text field on the right.
Degree obtained: Diplom Master PhD Dr. rer. nat. other
Please select degree from the pull down menu. If not listed, select "other" and specify it in the text field on the right.
in Discipline:
Date awarded: .
Date must be given as "month.year" (mm.yyyy).
Date attended, from: .
Duration of Studies. Dates must be given as "month.year" (mm.yyyy).
to: .
Thesis Advisor:
If applicable
Department:
Title of Thesis:
Please paste in the title and abstract of your thesis. The abstract should be a copy of the one printed in your thesis (maximum of 500 characters).
Abstract of Thesis:
Total Grade: out of possible
Please indicate your cumulative Grade Point Average (GPA) achieved (if applicable), together with the maximum GPA which can be achieved at your college or university.
Classification:
e.g. 'First Class Honours (Upper Division)'.
Publications related to this project:
Please list your publications related to this project (maximum of 500 characters).
b. Doctoral Degree (e.g. PhD, Dr. rer. nat)
College or University:
Please list the enrollment leading to your doctoral degree (PhD/Dr. rer. nat.; affiliated College/University).
City:
State:
If applicable
Country: Algeria Argentina Armenia Australia Austria Azerbaijan Bangladesh Belarus Belgium Belize Bolivia Brasil Bulgaria Burundi Cameroon Canada Chile Colombia Costa Rica Croatia Cyprus Czech Republic Dominican Republic Ecuador Egypt Eritrea Estonia Ethiopia Finland France Germany Ghana Greece Guatemala Honduras Hungary India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kenya Kuba Kuwait Kyrghyzstan Laos Latvia Lebanon Lesotho Lithuania Luxemburg Malawi Malaysia Mexico Moldova Morocco Myanmar Namibia Nepal Netherlands Nicaragua Nigeria North Korea Norway Oman P.R. China Pakistan Panama Papua New Guinea Peru Philippines Poland Portugal Romania Russian Federation Saudi Arabia Scotland Singapore Slovenia South Africa South Korea Spain Sudan Swaziland Sweden Switzerland Syria Taiwan Tanzania Thailand Tunisia Turkey Uganda Ukraine United Arabian Emirates United Kingdom USA Venezuela Vietnam Yemen Yugoslavia Zimbabwe Other (specified right)
Please select "Country" from the pull down menu. If your country is not listed, select "Other" and specify it in the text field on the right.
Degree obtained: Diplom Master PhD Dr. rer. nat. other
Please select degree from the pull down menu. If not listed, select "other" and specify it in the text field on the right.
in Discipline:
Date awarded: .
Date must be given as "month.year" (mm.yyyy).
Date attended, from: .
Duration of Studies. Dates must be given as "month.year" (mm.yyyy).
to: .
Thesis Advisor:
If applicable
Department:
Title of Thesis:
Please paste in the title and abstract of your thesis. The abstract should be a copy of the one printed in your thesis (maximum of 500 characters).
Abstract of Thesis:
Final Grade: out of possible
Please indicate your final grade achieved (if applicable), together with the maximum grade which can be achieved at your college or university.
Distinction:
Publications related to this project:
Please list your publications related to this project (maximum of 500 characters).
c. PostDoc (if applicable)
Institution or University:
Please list any postdoc position if applicable.
City:
State:
If applicable
Country: Algeria Argentina Armenia Australia Austria Azerbaijan Bangladesh Belarus Belgium Belize Bolivia Brasil Bulgaria Burundi Cameroon Canada Chile Colombia Costa Rica Croatia Cyprus Czech Republic Dominican Republic Ecuador Egypt Eritrea Estonia Ethiopia Finland France Germany Ghana Greece Guatemala Honduras Hungary India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kenya Kuba Kuwait Kyrghyzstan Laos Latvia Lebanon Lesotho Lithuania Luxemburg Malawi Malaysia Mexico Moldova Morocco Myanmar Namibia Nepal Netherlands Nicaragua Nigeria North Korea Norway Oman P.R. China Pakistan Panama Papua New Guinea Peru Philippines Poland Portugal Romania Russian Federation Saudi Arabia Scotland Singapore Slovenia South Africa South Korea Spain Sudan Swaziland Sweden Switzerland Syria Taiwan Tanzania Thailand Tunisia Turkey Uganda Ukraine United Arabian Emirates United Kingdom USA Venezuela Vietnam Yemen Yugoslavia Zimbabwe Other (specified right)
Please select "Country" from the pull down menu. If your country is not listed, select "Other" and specify it in the text field on the right.
Discipline:
Please enter the field you worked in.
Date attended, from: .
Duration of work. Dates must be given as "month.year" (mm.yyyy).
to: .
Advisor:
If applicable
Department:
Description of Research:
Please enter a brief description of your research (maximum of 500 characters).
Publications related to this project:
Please list your publications related to this project (maximum of 500 characters).
4. Academic Background and Skills
a. General
Experimental Neuroscience:
Education & background in experimental neuroscience. Please specify fields, experimental prepration, etc. (maximum of 500 characters).
Computational Neuroscience:
Education & background in computational neuroscience. Please specify fields, methods, etc. (maximum of 500 characters).
Mathematics / Physics:
Education & background in mathematics / physics. Please specify fields, methods, etc. (maximum of 500 characters).
Engineering / Computer Science:
Education & background in other relevant fields, e.g. engineering, computer science, etc. Please specify fields, methods, etc. (maximum of 500 characters).
b. Computer Skills
Computer Skills:
Programming Language, Operating System, Data Analysis and/or Modelling Tool (e.g. C++, Linux, Matlab, Neuron, etc.; maximum of 500 characters). If applicable, please indicate your level of knowledge (basic or advanced), otherwise write 'none'.
c. Language Proficiency and Tests taken (if applicable)
English Language Skills: native speaker advanced skills moderate skills basic skills none
Please indicate level of knowledge.
Computer TOEFL Test
Have you taken the computer based TOEFL test?
Computer TOEFL Score:
Computer TOEFL Date: .
Date must be given as "month.year" (mm.yyyy).
Paper TOEFL Test
Have you taken the paper based TOEFL test?
Paper TOEFL Score:
Paper TOEFL Date: .
Date must be given as "month.year" (mm.yyyy).
IELTS Test
Have you taken the IELTS test?
IELTS Score:
IELTS Date: .
Date must be given as "month.year" (mm.yyyy).
Other English Test:
Please specify
German Language Skills: native speaker advanced skills moderate skills basic skills none
Please indicate level of knowledge.
Other Language Skills:
Indicate language and level.
GRE General Test
Have you taken the GRE general test?
GRE General Score: - - verbal - quantitative - analytical
GRE General Date: .
Date must be given as "month.year" (mm.yyyy).
d. Honors / Scholarships / Prizes
Awards:
Please list any Honors / Scholarships / Prizes you have obtained (if relevant to this application) with dates and a short description (maximum of 500 characters).
e. Participation in Advanced Courses
Advanced Courses:
Participation in relevant advanced courses or summer schools, e.g. Arcachon, Edinburgh, Cold Spring Harbor, Woods Hole, Riken (maximum of 500 characters. If more space is needed, please add a separate list to your application package).
f. Other Publications
Other Publications:
Please list here publications that have not already mentioned in 3a through 3c (maximum of 500 characters. If more space is needed, please add a separate publication list to your application package).
g. Non-academic Interests
Interests:
If applicable, please list any non-academic interests that are not related to your university degree (maximum of 500 characters).
5. Motivation
Motivation:
What is your motivation to apply for the PostDoc program 'Computational Neuroscience' in Freiburg? Please describe your motivation and expectations (maximum of 500 characters).
6. Preferred Research Project
Research Project: Biomicrotechnology A3 (BFNT) FACETS NEUROTOX
Which research project do you apply for? In case you intend to bring your own funding and would like to work on your own research project, please select 'own' and provide a short description of that project under 'Reasons for this choice'
Reasons for Choice:
Please indicate the reason for your choice (maximum of 500 characters). In case you intend to bring your own research project, please provide here a short smmary of that project. If necessary, send us an additional file.
Alternative Project:
In case you would like to apply for a second project, please specify here the number of the project and your motivation (maximum of 500 characters).
7. Referees
a. Referee 1
Name:
Please list the name and address of the first referee who will write a letter of recommendation for you.
Address:
Institution:
Telephone Number:
Fax Number:
E-Mail Address:
Please give www address of institution or referee.
URL:
b. Referee 2
Name:
Please list the name and address of the second referee who will write a letter of recommendation for you.
Address:
Institution:
Telephone Number:
Fax Number:
E-Mail Address:
Please give www address of institution or referee.
URL:
8. How did you learn about this program?
Poster, Flyer
Please indicate how you learned about the program (check all that apply).
BCCN or BFNT website
E-mail
Friends, Other Students
College or University Office
Professor or Teacher
Conference, Workshop, Science or Education Fair
Please specify.
Other
Please specify.