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  • Ä؜}n¾zk^:3~eef;{d(Q[VW3w]Svy6򵄈E=Lg"Q-!$"<NehlHzi@=aNehlHz\ D #/xU=LSQ^K "O,`Z㨱!? $!Ŵ$&%.TfсōD7L&bjt2߻瞿{ygNJi6g+/I^,\SN>Tү7}*4>pwKif+Љy̑/ӉàZ~8WiA6TQ\.GN}dlGӜhlgySIg/j4yFgRNդMSmG%thmݷy)S=(F'w8HbKEO)SfN!ɅBX%oKgǽysr^+RsPTrdچڎmxGڗɇA&իY8D!'+"D!ojKb @=D!ojKb  %;xU=OQ=o@JmA,_A XDE BZRLtxhĨB!7M&&K/Ʉ=y{ce MV!9|;:\ʁH-jίrϽ`+|9Jr*1 =]4{Mf;)F_Y%My^w=m>m> I&>_[zuF5:Y)S;5ajV# >T9ퟶ`}"j}մ5k[\K!z/IL"#]3;QK3B)xwϰ)B}H*˦ړ66}yks K%ҠEwEog6wƦWq=>C/3ӵ2nG6w{rUojz2*B $ S AA@A@  pL CAS President s International Fellowship InitiativePIFI -Application Form-348: 7 Last Name 7 First Name 7 Citizenship 7 Nationality (Birth Country)  7Date of Birth dd/mm/yyyy 7Gender 7Office Information 7Home Information 7Address 7 Residence 7 Passport No. 7 Date Awarded 7 Institution 7Name 7Fax 7E-mail 7%Preferred address for correspondence: 7 Relationship 7Current Employer 7 Title/Rank 7 Department 7University/ College 7 Department 7Degree 7Major 7Field 7Title 71. PERSONAL DETAILS 72. CONTACT INFORMATION 7 Insitution 75. ACADEMIC BACKGROUND 7Institute/University, Division 7Host Researcher 7E-mail 7Tel 7Fax 7Room No. 7# 2nd CAS Host Institute(If you have)  7,7. ACADEMIC ACTIVITIES AND RESEARCH PROPOSAL 7ReadingWritingHearingSpeakingEnglish 7Chinese 7dd 7mm 7yyyy 7From 7To 719. LANGUAGE PROFICIENCY (5: excellent & & & 1: poor) 7PLEASE NOTE: If your application is successful, the photograph attached here may be used by CAS PIFI Program database and literature. 7 From(mm/yy) 7 To(mm/yy) 7 To(mm/yy) 7 4. Awards 7 5. Others 7 Others(Indicate)  711. Projects(as a project leader or a participant) 7Total 7 Relationship 7 Passport NO. 7 Date of Issue 7Place of Issue 7 Expiry Date 7No. 7Name(as in Passport) 7Type of fellowship 7CAS Host Institution 7Date 710. PAST CAS FELLOWSHIPS RECORD 7&12. WHERE ARE YOU HEARD OF THE PROGRAM 7 Amount($) 72. Publication 7/2. Outcomes resulting from the above fellowship 7Title of the lecture: 7-Timetables(dates of visit and key activities) 7' Whether you accept CAS's return visit? &  7Title of the research project: 78Timetables(dates of visit and the work of collaboration) 7013. RESEARCH PROPOSAL AND SUPPLEMENTAL DOCUMENTS 7 Abstract(no more than 300 words) 714. Declaration: 7 Signature 7 Middle Name 7x 3. EDUCATIONAL QUALIFICATION Please list all academic qualifications obtained since completing your secondary education   7 4. PROFESSIONAL RECORD IN CHRONOLOGICAL ORDER Please list all positions held after completing your university education, including career breaks/ 0 7^Accomplishement obtained in the last 5 years in chronological orders(starting from the latest) 7(6. CAS HOST INSTITUTIONS AND RESEARCHERS 7Main CAS Host Institute 7 8. PROPOSED TENURE AT CAS CAS 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.W X^ `l nx y  7CAS 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) 7OI 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. 7>Scientific field you are now working on  7V1. Have you ever received any fellowship support from the CAS? If so, please indicate. 7k 11. Will you be accompanied by spouse and/or offspring(s)? If so, please complete corrsponding information.; 7oName and address of next of kin or person in your country who should be contacted in the event of an emergency 7 Collaborator 7Professional Position 7Complete 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. 7Tel 7Tel 7Phone(M) 7Please submit the following documents along with this application form. 1.A recent passport-sized digital photograph (in colour) 2.Photocopies of academic certificates 3.Curriculum vitae 4.Research proposal(except applicants for distinguished scientist), including : objective;detailed description of project; timetable; the reason for this collaboration 5.Two recommendation letters(only applicants for postdoctoral fellows ), one recommendation must be prepared by your former supervisor  71Summary of research proposal at CAS(300 maximum ) 7H Colour Photograph Please copy and paste your digital passport photo here 7Application for Category 7< 1. Lecture tour information (Only for Distinguished Fellow ) 7Q 2.Research project information (Only for Visiting Fellow and Postdoctoral Fellow) 7Highest Degree Earned 7 3. 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