APPLICATION FOR ADMISSION TO

THIRD-CYCLE (POSTGRADUATE) STUDIES

Reg. No.



Personal data (to be completed by the applicant)
Civic registration number/Date of birth

Gender
Female Male
Surname

First name(s)

Home address

c/o

Postal/zip code

Postal address/City

Telephone

E-mail

Present affiliation, if any, with other university, please specify which*

Information about basic degree/higher education (to be completed by the applicant)
Degree/certificate/diploma

Date

University

Country

Studies intended by the application (to be completed by the applicant)
Subject

First term

Intended degree
PhD Licentiate

Change of subject



Date Signature
BESLUT
To be completed by the department
Antas till utbildning p forskarniv i mnet Fr.o.m. (datum)
Fakultet Institution
Antagningen syftar till
Doktorsexamen Licentiatexamen Doktorsexamen (senare del)
Avsedd frled i examensbenmning (omalternativ finns)
Huvudhandledare Institution Titel
Bitr. handledare Institution Titel

Anskan avsls

P fakultetsnmndens vgnar



Beslutsdatum Underskrift Namnfrtydligande

2(2)


Uppdok-enheten, 2011-11-23
COMPLETING THE APPLICATION FORM

For further information, see http://www.uu.se/en/node76. If you need more advice, contact the
responsible department or faculty.

Instructions for the applicant
Present affiliation, if any, with other university, please specify which: Only to be filled in if you are
employed by a university not offering third-cycle degrees in the relevant subject.
Information about basic degree/higher education: Certified photocopies of any degree certificates
should be attached to the application form.
Change of subject: The degree will be granted in the subject you have been admitted to. A change of
subject requires a new decision of admission. The decision must be made before the thesis is handed in
for printing.

Translation of the Swedish section of the form (not to be filled in)
DECISION
Admitted to third-cycle studies in the subject From. (date)
Faculty

Department

Intended degree
PhD Licentiate PhD (after Licentiate or equivalent degree)
Name of intended degree (if necessary)

Head supervisor

Department

Title

Deputy supervisor

Department

Title


Application rejected

On behalf of the Faculty Board


Instructions for the department
Antagningen syftar till: Anskan och antagning till utbildning p forskarniv avser ngot av alternati-
ven doktorsexamen (fyra rs heltidsstudier) och licentiatexamen (tv rs heltidsstudier). Om en person
tidigare antagits till utbildning p forskarniv syftande till licentiatexamen eller avlagt licentiatexamen
vid ett annat lroste anges doktorsexamen, senare del (tv rs heltidsstudier).
Avsedd frled i examensbenmning: Fylls i nr alternativa examensbenmningar finns inom fakulteten.
Detta gller teologisk fakultet (teologie eller filosofie), samhllsvetenskaplig fakultet (filosofie eller eko-
nomie) och teknisk-naturvetenskaplig fakultet (filosofie eller teknologie).

Individuell studieplan skall bifogas nr beslutet snds in till omrdeskansliet.

En kopia av den beviljade och diariefrda anskan skickas till Uppdok-enheten.