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EuroFIR Exchange Grant application form for Non EuroFIR partcipants

Please Note: Once you have completed this application form a copy will automatically be sent to your email address. Please make sure that the email address you use is the one you would like the form to be sent to.

	1.1 Applicant Details

	Last Name



	First Name



	Sex		Male Female



	Position



	Nationality



	Applicants email address



	Applicants telephone number (please include international dialing code)



	Applicants home institute (please include full address)



	Present employer



	Name and contact details (email/telephone) of supervisor at home insitute



	I would like to apply for an exchange period of

	Weeks



	Start Date



	End Date



	Application for (please choose the appropriate description)



	1.2 EuroFIR Host Institute Details

	Name, Address, Partner number and acronym of host



	Name of supervisor at Host Institute



	Reason why this Institute/Research group has been chosen for the exchange visit



	1.3 Details of Work Plan

	a) Aim of Project b) Summary description of the scientific work c) expected Outcome d) Budget: specification/motivation of all costs e)Please indicate how/if this training supports accomplishment of a specific planned deliverable or aim of EuroFIR or contributes to (further/future) integration of food composition reseach and food information in Europe.

	Plase attach document (ca 1-2 A4 pages)



	Please attach

	Your CV



	Applicants Signature



	1.4 Acceptance by the Host Institution

	This declaration is to be completed by (1) the head of the host research group, (2) the head of the host institute (or other appropriate individual), (3) the supervisor of the trainee/applicant at host institute.

	Applicants first and last name



	1. Full name and title



	email address



	Signature



	2. Full name and title



	email address



	signature



	3. Full name and title



	email address



	signature



	1.5 Acceptance of EuroFIR training support agreement by Applicants Home Institution

	This declaration is to be completed by (1) the head of the home research institute (or other appropriate individual), (2) the supervisor/line manager of applicant at home institute

	1. Full name and title



	email address



	signature



	2. Full name and title



	email address



	signature



	In addition to this electronic submission please send an original of your application document to the EuroFIR Secretariat, Training Bursaries Department, EuroFIR Bureau, Institute of Food Research, Norwich Research Park, Colney, Norwich, NR4 7UA United Kingdom by surface mail with the requested signatures.

	Any other comments/attachement you wish to include