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Professional Position
Application for Category
1. PERSONAL DETAILS
Last Name First Name Middle Name
Gender Passport No.
Citizenship Residence
Date Awarded Institution
Department Title/Rank
2. CONTACT INFORMATION
Office Information Home Information
Address Address
Tel Fax Tel
E-mail E-mail
Preferred address for correspondence:
Name Relationship Tel
University/ College Department Degree Major
CAS President’s International Fellowship Initiative(PIFI)-Application Form-
Complete all parts of this form in typescript as a Microsoft Excel file. You are also required to send a printed and signed copy to your main CAS host researcher for submition to CAS PIFI Program office.
Date of Birthdd/mm/yyyy
Nationality(Birth Country)
Highest Degre Earned
Current Employer
PLEASE NOTE: If your application is successful, the photograph attached here may be used by CAS PIFI Program database and literature.
Name and address of next of kin or person in your country who should be contacted in the event of an emergency
3. EDUCATIONAL QUALIFICATIONPlease list all academic qualifications obtained since completing your secondary education
Full Professor Associate Professor Assistant Professor Postdoctoral Researcher
A: Distinguished Scientist C: Postdoctoral Researcher
Office Address Home Address
B: Visiting Scientist
Insitution Department Field Title
5. ACADEMIC BACKGROUND
Accomplishement obtained in the last 5 years in chronological orders(starting from the latest)
1. Projects(as a project leader or a participant)
2. Publication
3. Patents
4. Awards
5. Others
6. CAS HOST INSTITUTIONS AND RESEARCHERS
Main CAS Host Institute
Institute/University, Division
Host Researcher E-mail
Tel Fax Phone(M)
Institute/University, Division
Host Researcher E-mail
Tel Fax Phone(M)
4. PROFESSIONAL RECORD IN CHRONOLOGICAL ORDER Please list all positions held after completing your university education, including career breaks
Scientific field you are now working on
2nd CAS Host Institute(If you have)
Management SciencesHealth Sciences
Life Sciences Earth Sciences Engineering&Material Sciences
Chemical Sciences Informaiton Sciences
Others
Mathematical&Physical Sciences
7. ACADEMIC ACTIVITIES AND RESEARCH PROPOSAL
1. What is your motivation to undertake the CAS PIFI program?Please respond in no more than 200 words.
Title of the lecture:
Abstract(no more than 300 words)
Timetables(dates of visit and key activities)
Title of the research project:
Summary of research proposal at CAS(300 maximum )
Timetables(dates of visit and the work of collaboration)
From dd mm yyyy To dd
1
2
Total
9. LANGUAGE PROFICIENCY (5: excellent ………1: poor)
English
Reading
Chinese
Reading
Writing Writing
Hearing Hearing
Speaking Speaking
2. Lecture tour information (Only for Distinguished Scientist )
Whether you accept CAS's return visit?
3.Research project information (Only for Visiting Scientist and Postdoctoral Researcher)
8. PROPOSED TENURE AT CASCAS PIFI program is normally offered during the calendar year(from 1st, January-31st, December).Please start your visit at CAS before 31st, December each year.
Others(Indicate)
Week(s) Month(s)
YES NO
5 4 3 2 1
5 4 3 2 1
5 4 3 2 1
5 4 3 2 1
10. PAST CAS FELLOWSHIPS RECORD
Type of fellowship Amount($) Date CAS Host Institution
2. Outcomes resulting from the above fellowship
No. Name(as in Passport) Relationship Passport NO. Date of Issue12
12. WHERE ARE YOU HEARD OF THE PROGRAM
13. RESEARCH PROPOSAL AND SUPPLEMENTAL DOCUMENTS
14. Declaration:
Signature Date
1. Have you ever received any fellowship support from the CAS?If so, please indicate.
11. Will you be accompanied by spouse and/or offspring(s)?If so, please complete corrsponding information.
CAS PIFI Program Office endeavours to provide fellowship information to a widest audience. You feedback will be helpful to us to improve our work. Please take a few minutes to answer the following questions.(Multiple answers are okay)
Please submit the following documents along with this application form.1.A recent passport-sized digital photograph (in colour) 2.Photocopies of academic certificates3.Curriculum vitae4.Research proposal(except applicants for distinguished scientist), including : objective;detailed description of project; timetable; the reason for this collaboration5.Two recommendation letters(only applicants for postdoctoral fellows ), one recommendation must be prepared by your former supervisor
I hereby declare that the above information is accurate and correct.I authorise the CAS PIFI program office to eletronically store and process my personal data for the purpose of assessment, statistics and evaluation organized by Bureau of International Cooperation,CAS.I promise to conduct the academic visit at CAS as I stated above.
YES NO
Article, Adverts in magazine, newsletterInternet search
Proposed host PIFI Fellows Chinese embassy in your country
CAS website Work colleagues
Others
Friends or acquaintances
Professional Position
Application for Category
1. PERSONAL DETAILS
2. CONTACT INFORMATION
Home Information
Fax
Phone(M)
CAS President’s International Fellowship Initiative(PIFI)-Application Form-
Complete all parts of this form in typescript as a Microsoft Excel file. You are also required to send a printed and signed copy to your main CAS host researcher for submition to CAS PIFI Program office.
Colour PhotographPlease copy and paste your digital passport photo here
PLEASE NOTE: If your application is successful, the photograph attached here may be used by CAS PIFI Program database
Name and address of next of kin or person in your country who should be contacted in the event of an emergency
lease list all academic qualifications obtained since completing your secondary education
From(mm/yy) To(mm/yy)
Assistant Professor Postdoctoral Researcher
C: Postdoctoral Researcher
Home Address
5. ACADEMIC BACKGROUND
Accomplishement obtained in the last 5 years in chronological orders(starting from the latest)
1. Projects(as a project leader or a participant)
2. Publication
3. Patents
4. Awards
5. Others
6. CAS HOST INSTITUTIONS AND RESEARCHERS
Main CAS Host Institute
Room No.
Room No.
4. PROFESSIONAL RECORD IN CHRONOLOGICAL ORDER lease list all positions held after completing your university education, including career breaks
From(mm/yy) To(mm/yy)
CAS Host Institute(If you have)
Engineering&Material Sciences
Others
Mathematical&Physical Sciences
7. ACADEMIC ACTIVITIES AND RESEARCH PROPOSAL
1. What is your motivation to undertake the CAS PIFI program?Please respond in no more than 200 words.
Title of the lecture:
Abstract(no more than 300 words)
Timetables(dates of visit and key activities)
Title of the research project:
Summary of research proposal at CAS(300 maximum )
Timetables(dates of visit and the work of collaboration)
mm yyyy
9. LANGUAGE PROFICIENCY (5: excellent ………1: poor)
(Only for Distinguished Scientist )
(Only for Visiting Scientist and Postdoctoral Researcher)
CAS PIFI program is normally offered during the calendar year(from 1st, January-31st, December).Please start your visit at CAS before 31st,
NO
5 4 3 2 1
5 4 3 2 1
5 4 3 2 1
5 4 3 2 1
10. PAST CAS FELLOWSHIPS RECORD
CAS Host Institution Collaborator
2. Outcomes resulting from the above fellowship
Place of Issue Expiry Date
12. WHERE ARE YOU HEARD OF THE PROGRAM
13. RESEARCH PROPOSAL AND SUPPLEMENTAL DOCUMENTS
14. Declaration:
1. Have you ever received any fellowship support from the CAS?
11. Will you be accompanied by spouse and/or offspring(s)?
CAS PIFI Program Office endeavours to provide fellowship information to a widest audience. You feedback will be helpful to us to improve our work. Please take a few minutes to answer the following questions.(Multiple answers are okay)
Please submit the following documents along with this application form.1.A recent passport-sized digital photograph (in colour)
4.Research proposal(except applicants for distinguished scientist), including : objective;detailed description of project; timetable; the
5.Two recommendation letters(only applicants for postdoctoral fellows ), one recommendation must be prepared by your former supervisor
I hereby declare that the above information is accurate and correct.I authorise the CAS PIFI program office to eletronically store and process my personal data for the purpose of assessment, statistics and evaluation organized by Bureau of International Cooperation,CAS.I promise to conduct the academic visit at CAS as I stated above.
NO
Chinese embassy in your country
Friends or acquaintances
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