Escolar Documentos
Profissional Documentos
Cultura Documentos
Fall 20
(indicate year)
Last Name: First Name: Middle Name(s): Date of Birth (dd/mm/yy): Nationality: Current Address* / City: Current Address* / Country: Current Address* / State: Latest Degree:
(awarded or expected this year)
AP TR DI R1 R2 EC FS FO C B A
Major Subject(s):
*for correspondence DURING the application and admissions process (i.e. valid until the end of March)
Contact: Prof. Dr. Michael Hrner, Program Coordinator, Grisebachstr. 5, 37077 Goettingen, Germany Phone: +49-551-39 12307/91244, Fax: +49-551-39 12308, gpneuro@gwdg.de, http://www.gpneuro.uni-goettingen.de
Last Name
First Name
Middle Name(s)
Nationality
male
female
single
married
No. Children
E-Mail Address
1.2 Current Address: (please indicate the address to be used for correspondence DURING the application and admissions process)
Street
City
Country
Telephone Number
1.3 Permanent Address: (if different from 1.2, please indicate the address to be used for correspondence AFTER the
application and admissions process, e.g. home address, address of parents or relatives)
Street
City
Country
Telephone Number
Please indicate how you learned about the program (check all that apply): Poster, Flyer, posted at/distributed by Internet Website Friends, colleagues, faculty members, other students College or University Office Conference/Workshop/Science or Education Fare, specify Other, specify
Contact: Prof. Dr. Michael Hrner, Program Coordinator, Grisebachstr. 5, 37077 Goettingen, Germany Phone: +49-551-39 12307/91244, Fax: +49-551-39 12308, gpneuro@gwdg.de, http://www.gpneuro.uni-goettingen.de
2. Education
2.1 Colleges or universities attended / degrees awarded or expected. College / University (most recent enrollment) College / University (previous enrollment)
Institution
Name City Country
Enrollment
Major Subject(s) Dates attended *Grade Point Average
from achieved till max. possible from achieved till max. possible
Degree
Title (e.g. B.Sc.; M.Sc.) Date of completion
*if applicable
Contact: Prof. Dr. Michael Hrner, Program Coordinator, Grisebachstr. 5, 37077 Goettingen, Germany Phone: +49-551-39 12307/91244, Fax: +49-551-39 12308, gpneuro@gwdg.de, http://www.gpneuro.uni-goettingen.de
Course Neuroscience Cell Biology Biochemistry Biotechnology Microbiology Botany Zoology Chemistry
yes/no / / / / / / / /
2.6 Language and Subject Tests: Have you taken or do you plan to take the Test TOEFL IELTS GRE General Test yes/no / / verbal / overall GRE Subject Test in:
enter name of test
Date (mm/yy)
Score
quantitative
analytical
Contact: Prof. Dr. Michael Hrner, Program Coordinator, Grisebachstr. 5, 37077 Goettingen, Germany Phone: +49-551-39 12307/91244, Fax: +49-551-39 12308, gpneuro@gwdg.de, http://www.gpneuro.uni-goettingen.de
3. Curriculum Vitae
Please list all educational and professional activities in reverse chronological order (from now till the end of high school) without leaving periods of more than one month unmentioned.
From - Till
Activity
Contact: Prof. Dr. Michael Hrner, Program Coordinator, Grisebachstr. 5, 37077 Goettingen, Germany Phone: +49-551-39 12307/91244, Fax: +49-551-39 12308, gpneuro@gwdg.de, http://www.gpneuro.uni-goettingen.de
Contact: Prof. Dr. Michael Hrner, Program Coordinator, Grisebachstr. 5, 37077 Goettingen, Germany Phone: +49-551-39 12307/91244, Fax: +49-551-39 12308, gpneuro@gwdg.de, http://www.gpneuro.uni-goettingen.de
5. References
Please list the names, positions, e-mail addresses and phone numbers of two referees who will write letters of recommendation for you. It is recommended that referees use the reference report form which is available on the programs website and send the letter directly to the coordination office until January 15.
Financial Aid / Application for Scholarships There is a limited amount of scholarships available through the program. If you intend to apply for one of them, please explain your financial situation on a separate form attached to this application. Admission to the program is unaffected by the need for financial aid!
Checklist for Application to the MSc/PhD/MD-PhD Program in Neuroscience Required Documents until January 15 (1) Cover sheet (p. 1 of this file): 1 copy. (2) Application Form (pp. 2-7 of this file): 2 copies of completed application form (signed). (3) Official Transcript / Record of Studies: of all colleges/universities attended; in English or German; 1 copy. (4) Diplomas: certificates of relevant examinations (e.g. Bachelors or Masters degree, Vordiplom, Physikum); in English or German; 1 copy of each document. (5) 2 Photographs: indicate your name on the back of both photos! (6) Financial Statement (p. 8 of this file): 1 copy. Notice that your application will NOT be processed if items 1-6 arrive late or are incomplete. Additional Documents (7) Reference Letters: signed letters of two academic teachers who are able to evaluate your personality, academic experience, and intellectual merit (in closed envelopes; preferably mailed directly to the coordination office). The use of the attached reference report form is recommended; reference letters submitted after January 15 will not be acknowledged in the evaluation of your application. (8) Proof of proficiency in English: if applicable (see website for details); preferably until January 15; acceptable after the application deadline. Optional (9) GRE Scores: official score reports of the Graduate Record Examination. The Subject Test in Biology, Chemistry, Physics or Cell and Molecular Biology is recommended but not required. How to proceed from here? After successful completion of your online registration, please send all documents listed in the checklist above to the program coordination office by air mail or surface mail. Notice that your application can only be processed after we have received your complete application form together with all relevant documents. Deadline for submission is January 15 of the year in which you intend to enter the program. Late or incomplete applications will not be accepted!
Contact: Prof. Dr. Michael Hrner, Program Coordinator, Grisebachstr. 5, 37077 Goettingen, Germany Phone: +49-551-39 12307/91244, Fax: +49-551-39 12308, gpneuro@gwdg.de, http://www.gpneuro.uni-goettingen.de
Do you require financial aid and want to apply for a scholarship through the program?
Admission to the program is unaffected by the need for financial aid!
yes
no
Printout
Please use the button below for printing this file. One hard copy should be kept for your records. Two hard copies of the entire file need to be submitted to the coordination office. Be reminded that this file does not allow you to save the data you have entered! All data will be cleared when closing the file.
Contact: Prof. Dr. Michael Hrner, Program Coordinator, Grisebachstr. 5, 37077 Goettingen, Germany Phone: +49-551-39 12307/91244, Fax: +49-551-39 12308, gpneuro@gwdg.de, http://www.gpneuro.uni-goettingen.de