A P P L I C A T I O N

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1 Fördernummer: Eingangsdatum: Aktenzeichen: Please send t: Universität Ulm Dezernat I Abteilung I-1, Frschung und Technlgietransfer Frau Sauter / Herr Dr Müller Helmhltzstraße Ulm A P P L I C A T I O N fr a dctral schlarship under the Pstgraduate Schlarships Act Mathematical Fundatins fr Risk, Reliability and Rebustness in Finance and Insurance mit Anwendungsbezug family name first name date f birth sex male female natinality pstal cde, place f residence street name, number hme phne number hme university / institute ffice phne number ffice bank details (incl SWIFT/BIC / IBAN) -Seite 1 vn 5-

2 D yu r yur partner receive child benefits under the Federal Child Benefit Act ( Bundeskindergeldgesetz )? n Number f children fr whm yu receive child benefits Des yur partner receive benefits under the Pstgraduate Schlarships Act (LGFG) r frm any ther public r private spnsr with similar bjectives? n Please indicate spnsr, purpse and duratin f the fellwship Did yur partner apply fr such benefits t any ther spnsr? nein Intermediate and final examinatins taken in the cntext f university studies name f exam exam subject university date f exam result (grade) Details f the scientific prject faculty date f acceptin as dctral candidate subject f dctral thesis institute -Seite 2 vn 5-

3 starting date f dctral thesis (expected) cmpletin date f dctral thesis Dctral thesis adviser and 1st referee t this applicatin (name, institute) 2nd referee t this applicatin (name, institute) D yu expect t spend time abrad (utside Germany) fr wrking n yur thesis? n Cuntry, research institutin, perid f time, funding Have yur dctral studies been r are they currently supprted by any public r private spnsr? n spnsr, perid f time, amunt financially, kind f benefit (eg material csts, cntributin t travel expenses) Emplyment, Incme Are yu currently in gainful emplyment r d yu pursue any ther kind f activity (training, educatin, student assistant)? If s, what d yu d? D yu intend t pursue a gainful emplyment r any ther kind f activity cmpatible with the schlarship during the term f yur schlarship? If s, what and hw much time d yu plan t wrk? -Seite 3 vn 5-

4 I declare, that I d nt have an incme at the effective date f the schlarship My ther incme, when starting the schlarship, will amunt t EUR (pre tax) per mnth I have an emplyment cntract with (emplyer), amunting t hurs per mnth My ther incme during the first year f the schlarship is expected t amunt t EUR (pre tax) I cnfirm that I will nt receive any ther incme during my schlarship (etc unemplyment benefits, alimny etc) I d nt receive any ther schlarship Please add the fllwing dcuments / certificates This applicatin is accmpanied by: a wrk schedule cmprising a timeframe referee s statement by academic supervisr (1st referee) referee s statement by anther prfessr (2nd referee) cpies f university examinatin certificates (University may request cpies t be certified) cnfirmatin by the Faculty f acceptance as a dctral candidate and my being academically super vised by a university lecturer a curriculum vitae prviding infrmatin n, in particular, previus studies, special achievements and experiences prf f incme situatin (incme tax assessment r ntice f annual adjustment f wage tax fr the calendar year preceding this applicatin*, payslips frm emplyer, ntificatin f schlarships etc) prf f payment f child benefits The fllwing dcuments are nt attached and will be handed in as sn as pssible: Declaratin f the Applicant I cnfirm the crrectness f all data indicated by me and cntained in the attached declaratins I have taken nte f the prvisins f the Landesgraduiertenförderungsgesetz and f the Statutes f Ulm University regarding the implementatin f the LGFG, especially thse relating t an exclusin f financial supprt and the cnsideratin f incme Shuld I be awarded a schlarship, I undertake, T endeavur in the required manner and t a reasnable extent t realise the bjectives f the pstgraduate schlarship prgramme, Nt t pursue any training r any ther activity that are nt cmpatible with the schlarship, Nt t accept any further schlarships frm any ther agency during the term f my schlarship T ntify the university immediately f the cmpletin f my dctral thesis r, respectively, f a discntinuatin r interruptin f my dctral studies r cntinuatin theref at anther university, T ntify the university immediately f any change in circumstances relevant fr the calculatin f the amunt f my schlarship r the cntinuing payment theref such as the award f anther schlarship, the taking up f training r f gainful emplyment, any changes in my incme situatin, the number f -Seite 4 vn 5-

5 children and adjustment f child benefits paid, independently f whether these changes entail an increase r a decrease in the amunt f the schlarship, T prvide University f Ulm with all data required under the Landesgraduiertenförderungsgesetz (LGFG) and the Statutes f University f Ulm in cmpliance with the Landesgraduiertenförderungsgesetz, in particular t submit the reprts required under sectin 9 LGFG and t infrm the university f the result f my dctral studies, T immediately ntify the University f any changes f address during the term f my schlarship and my bligatin t reprt Date signature Please pass in tw cpies f this applicatin and please d nt staple them Applicatins will nt be returned after assessment, therefre please d nt send riginals -Seite 5 vn 5-