APPLICATION FORM FOR ADMISSION PhD STUDENT TO ASCI

1. Title, all first names, last name, and sex of the PhD student:

Date and place of birth (if not within the Netherlands, also state country of
birth):

2. Work address of PhD student

Faculty/Company:
Address:
Phone:
Email:
WWW-site:

3. Data PhD project

Date commencement of employment:
Date the doctorate is obtained (estimate):

Name doctoral thesis supervisor:

Name supervisor, if any:

Title of research project (in English):

ASCI theme of research project (A, B, C, D):

A: High Performance Computing and Computational Science
B: Large scale distributed Information Systems and Embedded Systems
C: Image and Multimedia Sensing, Processing, Interpretation and Visualisation
D: Multimedia Information Systems

Description of the research (on appendix, max. 1/2 A4, in English).

Source of funding (1st, 2nd or 3rd flow of funds) and name of employer, if
any:

4. Desired working hours in ASCI, expressed in full-time equivalents (if less

than 0.7 full-time equivalents, add motivation by supervisor/doctoral thesis
supervisor):

5. Curriculum vitae (on separate sheets; remains confidential).

6. Composition Individual Training Program (from 6.1 to 6.5 inclusive)

The individual training program needs to consist of at least 24 ECTS points.

I. The individual training program has to be specified now and needs to

include at least either 3 courses of 4 ECTS points, or 2 courses of 4 ECTS
points and 1 summer school of 2 to 4 ECTS points depending on its duration and
the amount of work involved, and to be decided by the ASCI Education
Committee. From these elements at least 2 elements should be taken with ASCI.
All courses must be at PhD level. The program is not final, later on chosen
courses may be exchanged for other ASCI courses. This section should account
for at least 12 ECTS points.

II. The individual training program needs to include at least 3 supervised

lectures: Each PhD student is assumed to participate in local discussions of
work progress, seminars, or lectures on literature. This element equals 6 ECTS
points.

III. The education plan should include the attendance of conferences or

workshops (at least 3) and/or courses on writing or presenting. Completing a
course on writing or presenting a paper counts for 2 ECTS points. This section
should account for at least 6 ECTS points.
See www.asci.tudelft.nl under "Courses & Calendar" “Individual Education
Plan”

6.1 Courses (4 ECTS points each) (institute, code and title):

6.2 Summer schools (2 to 4 ECTS points if report has been approved) (if
already known: name, dates):

6.3 Conferences or Local Workshops (2 ECTS points for each paper) (if already
known: name, dates, title own paper):

Total number of ECTS points to be obtained (at least 24):

Place/date:

signatures from:

(Doctoral thesis supervisor) (Supervisor) (PhD student)

ASCI Office
phone: 015 2788032
p/a Faculty EWI-TU Delft/ P.O. Box 5031/ 2600 GA Delft
asci-office@tudelft.nl

Email COMPLETED FORM duly signed for agreement TO EMAIL ADDRESS ABOVE