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Application form (Part I) Pasteur Paris University International Doctoral Program

Deadline: December 15th, 2012 The completed form must be sent by the host lab to phd@pasteur.fr The subject of the mail shall indicate the name of the applicant and of the host lab. Please read carefully the application procedures, including the eligibility requirements, indicated on the web site.

(4 pages maximum)

Family Name, first name: Birth (date dd-mm-yyyy, place): Citizenship (s): Full Address: Email: Name of the laboratory for which you are applying: 1. ACADEMIC TRAINING High school education (indicate your last high school diploma):

Photo (optional)

University education List all universities and other academic institutions that you have attended since high school. (Indicate all university diplomas you have received so far, specifying the University, country, year, and grade or marks for each degree) B.Sc.: Indicate the title of your work, the lab address and the time period. Master: Indicate the title of your research work, the lab address and the time period in which the work has been or will be completed. (In the event of no formal masters degree obtained or in preparation, please describe why you think your training is equivalent.) Are you currently preparing a diploma? If yes, which one? (Specify the University, country, and title of the diploma, as well as the expected due date): 2. INTERNSHIPS: (Work experience in laboratories outside your coursework, specify dates of each) 3. OTHER DIPLOMAS OR QUALIFICATIONS, IF ANY: 4. SUMMARY OF YOUR PREVIOUS RESEARCH PROJECT (half page): 5. TECHNICAL SKILLS:

6. AWARDS: 7. LANGUAGES (written and oral, specify if : fluent, very good, good, basic): 8. PUBLICATIONS OR PRESENTATIONS AT CONFERENCES (indicate all authors, and for the whether it was a poster or oral presentation at the conference) 9. WORK EXPERIENCE: Occupations other than as a student in which you might have been engaged (type of activity, employer, dates of employment. Include military service if applicable, teaching, voluntary work or other extra-curricular activities):

Application form (Part II) Pasteur Paris University International Doctoral Program
Copy of students passport (or identity card for members of the European Community) and copy of last diploma:

Application form (Part III) Pasteur Paris University International Doctoral Program
Personal statements/Questions (maximum 2 pages)
How did you learn about this program? What would be a good way to promote this program at your university (specify for example contact people, internet sites, email address of undergraduate office) Why did you apply for this program? What are your career plans and what do you plan to do immediately after the Ph.D.? What are your non-academic interests? (Optional)

Application form (Part IV) Pasteur Paris University International Doctoral Program
Letter of motivation by the student
List here your main subjects of scientific interest (experimental, theoretical or issue-oriented). Give the reasons for the choice of the proposed host laboratory. Explain how your background and our program fit together (maximum 1 page).

I certify that all the information in this application is correct and complete to the best of my knowledge. Name:



Application form (Part V) Pasteur Paris University International Doctoral Program

2 RECOMMENDATION LETTERS (below is a MODEL, please send it to the referees)
The recommendation letters should be send to phd@pasteur.fr. The name of the host lab should be listed in the subject of the email. A model of the letter is shown below.

Date: Complete Address of the referee (Institution address) Name of the candidate Please indicate how you know the candidate and how you would evaluate her/him regarding criteria like: Technical ability, Scientific knowledge, Intellectual level, Creativity, Communication skills, Motivation, Maturity, Team Work, Rapport with Mentor, Flexibility, English knowledge. Name: Signature of the referee:

Application form (Part VI) Pasteur Paris University International Doctoral Program Letter of introduction of the candidate by the Host laboratory at IPP
(to be completed by the host lab, in english)

This letter must be signed by the Head of Unit or G5. Note: One same research team can propose only one candidate. The candidate can apply for several labs at Institut Pasteur. S/He can apply to any lab of his/her interest. If the candidate is selected by more than one lab, s/he has to choose one lab before submitting the application.

Application form (Part VII) Pasteur Paris University International Doctoral Program Description of the Ph.D. project (to be completed by the host lab)
Name of the candidate Citizenship(s) Name of the Unit/G5 Head of Unit/G5 IP Department Doctoral school : : : : : :

Ph.D. Director or scientist advisor of the student: HDR (yes/no or expected date): Specify name of team (Equipe daccueil) if different from the Unit: Number of HDR and Ph.D. students presently in the team: Summary of the PhD Project : give the title and a description of the Ph.D. project, including background, objectives and experimental approaches (3 pages)