MEDRC | PhD Application Form

Personal Information

Given Name(s)*

Family Name*

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Date of Birth*

Gender*

Male
Female

Personal Email*

Mobile Country Code*

Mobile No.*

Skype Contact Name

Passport Number

National ID Number

National ID Type

Please let us know what the type of ID is (e.g. Driving License).

Address*

Address City ZIP / Postal Code

Country*

Educational Background

Please detail your past academic achievements

Degree Awarded	Field of Study	GPA	Have You Graduated	Year of Graduation	University
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List any additional academic qualifications, distinctions, or awards / scholarships you have received relevant to the application or MEDRC Fellowship award program:

Work Experience

Employer	Position	Responsibilities / Achievements	From	To
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There are no Work Experience Records.

Maximum number of work experience records reached.

Do you plan to work during your MEDRC Fellowships?

Academic Highlights

Mention any academic accomplishments such as publications, thesis or conferences

Title	Summary	Journal/Event	Date
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There are no Highlights.

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Program of Intended Study

Why are you applying for funding? Use this section to talk about what your will be studying.

Student ID Number*

University Name*

Department*

Have you been accepted to the PhD program?*

Full Name of Program*

Title of Proposed Dissertation

Program Start Date*

Thesis Supervisor Full Name*

Thesis Supervisor Email*

Thesis Supervisor Telephone Number*

Supporting Documentation

Please upload the below listed documents in order to complete your application. Please ensure that all file names are in English.

National ID*

Please upload a copy of your National ID / Passport

Drop files here or

Statement of Purpose*

Please upload a personal statement, one page maximum, signed by the applicant

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Resume / CV*

Please ensure your CV is 4 pages max and fully up to date

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Letter of Recommendation*

3 letters required. At least one must be from University Professor directly familiar with your academic work.

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Proof of Qualifying Degree*

Copy of official diploma confirming conferring of degree

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Academic Transcripts

Official transcripts listing all coursework and grades

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TOEFL / IELTS score*

Proof of minimum qualifying score in English proficiency

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PhD Research proposal*

Full research proposal, considering the scope and approach of your research, including budget and research costs, timeline, milestones and deliverables

Drop files here or

Declaration

To the best of my knowledge, the information I have provided in this application along with any attached supporting documents are accurate and complete. I understand that my application is not valid unless all required information and supporting documents are provided to MEDRC.

I agree to inform MEDRC Water Research (fellowships@medrc.org) immediately of any change in the above information, or any further information that might affect my eligibility or consideration as an Innovation Initiative award recipient.

Signature*

Please enter your name to confirm that you agree to the terms above.

PhD Application Form

Personal Information

Educational Background

Work Experience

Academic Highlights

Program of Intended Study

Supporting Documentation

Declaration

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