Scholarships and Fellowships

Post-Doctoral
Fellowship
Application Form

Please complete in English (type or print) using extra pages where necessary

A. PERSONAL DATA

 Surname :        
 First name/s :   
 E-mail address : 
 Postal address : 
		  
 Date of Birth  : (D/M/Y)  Age :  Sex (M/F) 
 Place of Birth :  Nationality : 
 Marital Status : 
 No. of Children and Age:

B. EDUCATION

 Academic Qualifications :
 (University or equivalent)  Years attended  Major fields of study   Degree
                               From / To

C. SCIENTIFIC PUBLICATIONS

List original papers in peer reviewed journals and for the past five years only :

D. EMPLOYMENT

 Present position :  
 Institution :       
                            
 Dept./Faculty :     
 Address :           
                     
                     
                     Tel:  Fax:  Telex:  


 Current research and areas of interest : 
 


 Institutes of work since end of formal education :
 Research Institution or University   From / To   Duties / Responsibilities

E. LANGUAGES

Mother tongue :
Other languages ReadComprehend SpeakWrite
easilynot easily easilynot easily easilynot easily easilynot easily

F. PREVIOUS FELLOWSHIPS

 List previously held fellowships from other organizations:
      Organization              From / To           Research

G. AREA OF RESEARCH IN WHICH YOU WISH TO BE INVOLVED (Proposal may be attached) :

H. BUDGET REQUEST (25 Baht = US$ 1)

 Salary  (maximum 300,000 Baht)
 Research Supplies  (maximum 100,000 Baht)
 Travel Plus Expenses  (maximum 50,000 Baht)

Please submit application form to :
Director
National Science and Technology Development Agency
Gypsum Metropolitan Tower,
18th Floor, 539/2 Sri-Ayudhya Rd.,
Rajdhavee, Bangkok 10400
Thailand. 

      1. Curriculum Vitae
      2. Evidence of continuation of present employment upon completion of fellowship



 Signature : _________________________________      
 Date      : ___________