EURNEX Mentor/Trainee Programme Application Form

All spaces marked with an asterisk (*) are required. If any spaces are forgotten, however, the form will be returned with the missing fields highlighted - no data will be lost.

Jana Bidlova (e-mail: jbidlova@fd.cvut.cz).

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General Details
* Surname:
* Forename:
* Date of birth:
* Place of birth:
* Degree:
* Current occupation:
* Email address:
* Telephone number:
Fax number:
Areas of Interest
I am interested in participating at the EURNEX Mentor/Trainee Programme in 2006/07 in the following research field(s):
Pole 1: Strategy and Economic
Pole 2: Operation and Performances
Pole 3: Rolling Stocks
Pole 4: Product Qualification
Pole 5: Intelligent Mobility
Pole 6: Safety and Security
Pole 7: Environment and Energy Efficiency
Pole 8: Infrastructures
Pole 9: Human Factors
Current Activities
With specific regard (describe your current research activity here):
* Activities description:
Check for the availability of a Mentor among the following list, in the period (indicate a 12/18 months period):
OR help you in identifying your Mentor for the period (indicate a 12/18 months period):
Tutor's Reference and Details
Letter of reference - tutor's confirmation/recommendation for applicant's participation in the mentor / trainee programme (short description of the applicant, her skills and activities):
* Applicant description:
* Name of the tutor:
* Address of the institution:
* Tutor's email address:
* Tutor's telephone number:
For further information, please contact Jana Bidlova (e-mail: jbidlova@fd.cvut.cz). On submission, a copy of the completed form will be provided for you to print or save for your own records.