GREENCYCLESII

Eligibility Form

Marie Curie Fellowship FP7 Initial Training Network – Anticipating climate change and biospheric feedbacks within the Earth system to 2200 (GREENCYCLESII) (Ref: 238366)

This form is to be completed by all applicants.

Surname/Family name:_________________ First/Given name(s):____________________

Project Title (e.g. from web/ job advert): If applied for more than one project, state in the order of priority: __________________________________________________________________________

__________________________________________________________________________

Host Institution:____________________________________________________________

Nationality:________________________________________________________________

Dual Nationality: If holding more than one nationality, please give details of nationality(ies) held:______________________________________________________________________

Gender: Male/Female

Residence: Please indicate the country(ies) of residence and the main activity (work, studies, etc) during the five years prior to the planned start date of the project for which you are applying. Please include details of the dates you were awarded your degree (s).

Country	Activity	Start date	Completion date

Research experience: Please indicate research training and research activities from the date when first degree was awarded. This does not include periods of employment if research training is not present.

Research training programme	Brief description of activity	Start date	Completion date

Language: Please provide details of any languages you are proficient in and qualification achieved.

	Language	Qualification
1^st language
Other language
Other language
Other language

Family Status: Married or living as married Single No of dependent children _________

Have you applied for or been awarded any other type of Marie Curie fellowship? Yes/No

If yes please give details:

______________________________________________________________________________

Declaration: I certify that the information given in this application and in the supporting documents is accurate and complete. I understand that the submission of inaccurate information may be sufficient cause for refusal of admission or termination of registration. I agree that a summary of the research training project and contact information may be published on the European Commission website and will be forwarded to the Marie Curie Fellowship Association.

Signature ____________________________________Date __________________________

GREENCYCLESII

Initial Training Network on global biosphere-climate interactions

Eligibility Form