University of Cologne International International Global Focus Areas DIES ProGRANT Information for Applicants Malaysia Application Form Malaysia Application Form4 eo Aa Mala IF] Personal Information Title* Or ¥ First Name * Last Name* Gender * Date of Birth * BH demmyy Current Age: * ex 23 Citizenship * lrother, please spect: Highest level of Education: * Contact Information Malling Address (address you prefer to be reached at) City * Country Zip Code * E-mal* English Skills ex: myname@example.com Phone number *Please rate your ability on a 1-5 scale (1 being beginner and § being fluent) * 1 2 2 ‘ 5 Wang © pecking ® Former Scholarships Please check all that apply: * DAAD @ Other German Institution None Ifyou have received a scholarship from a German Instituion (DAAD, AvH, GIZ, etc) please specify the name of the scholarship and year when you received i: Open Questions Research Field: (0.9 Geography, Biology, ete.)* Home Institution: * What is your research focus? * What is motivating you to apply for DIES ProGRANT? * Attachments Please ttle all documents (word or pal according to the following example: “familyname_frstname_expose” Exposé * Choose File No file chosen ov" Chaase File No file chasenLetter of Support ™ Choose File No file chosen How did you hear about us? Please share with us how you heard about the program Friend or Colleague Intormet Search Flyer Facebook University Other General Data Protection Regulation ‘tessivw eortal uni-koeln deldatenschutz him? &L=t, In the framework ofthis project, your personal data such as Name, Gender, Date of Birth, Position and Home University willbe given to the following partes: a) Consulates and Embassies (for informational purposes) b) Hotels, partner universities and our travel agency (for logistical purposes) ©) DAAD (for statistical purposes) ‘You can revoke your consent to the processing of personal data at any time. This does not affect the selaction process or participation in ProGRANT. Confirmation | have read all information on the course and am available to participate during both on-site Seminars, | hereby confirm that all ofthe information provided above is accurate | hereby give my consent tothe processing of my personal data Submit