IMPRS4LS Application



	This form must be completed in English. All fields marked with an " ! " are obligatory. Please check all entries before you click the SUBMIT button. Please note that you cannot change your data entries after submission! After successful online submission, you will receive a confirmation at the e-mail address you provided. This e-mail message will contain your registration code. Please refer to this code for all correspondences with the IMPRS office.

1. Personal Information
	1.1 Personal data

!	Family Name
!	Given Name
	Middle Name(s)
!	Sex	female male
!	Date of birth	Day: Month: Year:
!	City of birth
!	Country of Birth
!	Nationality
	Marital status	single married
	Do you have children	yes no
!	Email (only one)
	(Note: Your e-mail address must be valid and reachable during the entire application process)

	1.2 Address (Please indicate the address under which you will be able to receive correspondence during the application process)

!	Street
!	Postal code
!	City
!	Country
!	Telephone number (include country code)

	1.3 Motivation and Research Experience
!	Primary discipline
	(please select the terminology that best describes your primary field of study)
!	Statement of motivation for the IMPRS
	[max. length 400 Words]

2. Education
	2.1 Colleges or universities attended (most recent first)

!	College or University
!	City
	State
!	Country
	Link to webpage
!	Attended from	Day: Month: Year:
!	Attended until	Day: Month: Year:
!	Degree awarded
!	Distinction	Other:
!	Date awarded/expected	Day: Month: Year:
!	Major field(s) of studies (e.g., MSc in Cognitive Neuroscience)
!	Thesis Title
!	Thesis Supervisor(s)
!	Thesis Summary
	[max. length 500 Words]
	Final grade/score
	Max. possible grade/score
	Min. possible grade/score
	Classification (e.g., GPA)

	2.2. Colleges or universities attended (earlier/recent enrollment)

	College or University
	City
	State
	Country
	Link to webpage
	Attended from	Day: Month: Year:
	Attended until	Day: Month: Year:
	Degree awarded
	Distinction	Other:
	Date awarded/expected	Day: Month: Year:
	Major field(s) of studies (e.g., MSc in Cognitive Neuroscience)
	Thesis Title
	Thesis Supervisor(s)
	Thesis Summary
	[max. length 500 words]
	Final grade/score
	Max. possible grade/score
	Min. possible grade/score
	Classification (e.g., GPA)

	2.3. Colleges or universities attended (earlier/recent enrollment)

	College or University
	City
	State
	Country
	Link to webpage
	Attended from	Day: Month: Year:
	Attended until	Day: Month: Year:
	Degree awarded
	Distinction	Other:
	Date awarded/expected	Day: Month: Year:
	Major field(s) of studies (e.g., MSc in Cognitive Neuroscience)
	Thesis Title
	Thesis Supervisor(s)
	Thesis Summary
	[max. length 500 words]
	Final grade/score
	Max. possible grade/score
	Min. possiblegrade/score
	Classification (e.g., GPA)

	2.4. Colleges or universities attended (earlier/recent enrollment)

	College or University
	City
	State
	Country
	Link to webpage
	Attended from	Day: Month: Year:
	Attended until	Day: Month: Year:
	Degree awarded
	Distinction	Other:
	Date awarded/expected	Day: Month: Year:
	Major field(s) of studies (e.g., MSc in Cognitive Neuroscience)
	Thesis Title
	Thesis Supervisor(s)
	Thesis Summary
	[max. length 500 words]
	Final grade/score
	Max. possible grade/score
	Min. possiblegrade/score
	Classification (e.g., GPA)

	2.5. Colleges or universities attended (earlier/recent enrollment)

	College or University
	City
	State
	Country
	Link to webpage
	Attended from	Day: Month: Year:
	Attended until	Day: Month: Year:
	Degree awarded
	Distinction	Other:
	Date awarded/expected	Day: Month: Year:
	Major field(s) of studies (e.g., MSc in Cognitive Neuroscience)
	Thesis Title
	Thesis Supervisor(s)
	Thesis Summary
	[max. length 500 words]
	Final grade/score
	Max. possible grade/score
	Min. possiblegrade/score
	Classification (e.g., GPA)

3. Qualification

3.1. Research experience

Please specify any relevant research experiences outside of your thesis work, such as lab internships. Indicate the supervisors/collaborators, lab location, project title, and duration of your involvement. Describe succinctly your tasks and responsibilities (e.g., 7 Tesla MRI data collection, multivariate analysis of 128-channel EEG data).

[Max. length 200 words]

3.2. Relevant coursework

Please specify courses and grades obtained relevant for this application (include transcripts as supporting document in section 9).

[Max. length 200 words]

3.3. Awards, honors, prizes, scholarships

Please list any notable achievements relevant to this application (include dates and a short description of each entry)

[Max. length 200 words]

3.4. Other relevant studies, teaching experiences, technical skills etc

Please note anything which is valuable for your application

[Max. length 200 words]

3.5. Language skills

Please note: Providing English test results or documentation is strongly recommended, but not required.

Did you take an English test?

(upload the results as a supporting document in section 9)

Score

Max. score possible

Date

Day: Month: Year:

Which other language(s) do you speak and at what proficiency level? (upload language test results as a supporting document in section 9, if applicable)

[Max. length 50 words]

3.6.Graduate Record Examinations (GRE)

Did you take a GRE test?

Score (%)

verbal
quantitative
analytical

Date

Day: Month: Year:

4. Publications and Conferences
	4.1. Publications
	Please indicate any research articles (published or submitted to peer-reviewed journals) which you have (co-)authored.

!	Total numbers of publications
	First author publications
	List of publications (most recent first). Format: 1st author, journal, vol., pages, year
	[Max. length 200 words]

	4.2. Conferences
	List of conferences (most recent first) Format: conference title, location, dates, type of participation: speaker/poster presentation/etc.
	[Max. length 200 words]

5. References
	Please be sure to enter the correct institutional e-mail addresses of your referees. Upon successful submission, your referees will automatically receive an e-mail invitation to submit a letter of recommendation on your behalf. An e-mail confirmation will be sent to you once the referee has done so. You are responsible for ensuring that the letters are submitted on time. IMPORTANT: Ideally, potential supervisors and members of their research group must NOT also serve as referees to avoid any conflict of interest in the selection process. Please contact the IMPRS Office (imprs@mpi.nl) if you have any doubts.

	5.1. Referee 1
!	Family name
!	Given name(s)
!	Academic title	Prof. Dr. Dr.
!	Institution
!	Address
!	Phone (include country code)
!	Email-address (only one)
	URL
	(please provide www address of institution of referee)

	5.2. Referee 2
!	Family name
!	Given name(s)
!	Academic title	Prof. Dr. Dr.
!	Institution
!	Address
!	Phone (include country code)
!	Email-address (only one)
	URL
	(please provide www address of institution of referee)

6. Research preferences
	Please select and rank up to three potential supervisors. Note: this selection is not binding. For an overview, please go to http://www.mpi.nl/education/imprs-for-language-sciences
	6.1. Potential Supervisor
!	1. First Choice
!	2. Second Choice
	3. Third Choice

	Statement of motivation for selected potential supervisor(s)
	[Max. length 200 words]

7. Survey
	How did you learn about the Fellowships offered by the IMPRS (e.g., via AMLAP mailing list)?
!	Please specify
	[Max. length 50 words]

8. Statutory declaration
!	Assurance of complete and truthful information and statutory declaration	- I confirm that all information given in the online registration is complete and correct. - Copies of requested documents are true copies without any changes. I am aware that false information, given intentionally or unintentionally, will be considered a misdemeanor and will immediately result in my being excluded from the admission procedure or – if later detected – from the membership of the International Max Planck Research School for Language Sciences. - I declare that I am fluent in written and spoken English. - I consent to the storage of my personal data for application and admission purposes. According to the German privacy law all data of not admitted applicants will be deleted after completion of the selection procedure.

9. Upload and Submission
!	Please upload passport photo
	(highly encouraged, but not mandatory)
	Only JPEG allowed

!	Please upload supporting documents
	(as one PDF file saved as: GivenName_FamilyName.pdf This must match your entries in Section 1 above)

	Supporting documents are:
	* Copy of your degree certificate(s) (BSc, MSc, etc.)
	* Copy of your transcript(s) of records (BSc, MSc, etc.)
	* Language test results (if applicable)
	* GRE test results (if applicable)



	Please note that you *cannot* change your data once submitted!

	Press SUBMIT button to upload and submit your entries and supporting documents