I-Identification of the applicant
Name

First name

Grade

Email

Specialty

Function
—Please choose an option—Teacher researcherUniversity hospital research professorTeacher-researcher preparing the doctoral thesis from the second yearUniversity hospital research professor preparing the doctoral thesis from the second year
Department

Faculty/Institute

University diploma

Work certificate

Order of tenure

II Internship project:
Goal of the Internship
—Please choose an option—ExperimentationArticle/book writingExchanges/cooperation
Host institution

Countries

Duration

Complete and detailed project specifying the goal, the methodology and the expected goals

I-Identification of the applicant
Name

First name

Email

Quality
—Please choose an option—PhD studentResident
Department

Faculty/Institute

University diploma

Registration certificate for the current year

Year of first registration

EmployeeUnemployed
II Internship project:
Goal of the Internship
—Please choose an option—ExperimentationFinalization of the thesisArticle writing
Host laboratory

Host institution

Countries

Duration

Letter of invitation (for doctoral students only)

I-Identification of the applicant
Name

First name

Email

Grade

Specialty

Function
—Please choose an option—TeachersUniversity Hospital ProfessorClass A lecturerClass A university hospital lecturerTeacher researcherUniversity hospital research professorClass B lecturerClass B university hospital lecturerResidentPhD student
Department

Faculty/Institute

University diploma

II Internship project:
Title of the event

Country

Index

Data base

longer term,

Theme
—Please choose an option—Citizen's healthFood SafetyEnergy SecurityOther
Type of Event
—Please choose an option—CongressSeminarScientific DaysWorkshop
Application for participation validated by the thesis director (for doctoral students)

Acceptance letter

Program of the event

Copy of entry

I-Identification of the applicant
Name

First name

Email

Specialty

Grade
—Please choose an option—ProfessorUniversity Hospital ProfessorClass A lecturerClass A university hospital lecturerClass B lecturerClass B university hospital lecturer
Department

Faculty/Institute

University diploma

Work certificate

Order of tenure

II Internship project:
Goal of the Internship

Host institution

Countries

Duration

Agreement with the establishment abroad

Complete and detailed project specifying the goal, the method and the expected results:

I-Identification of the applicant
Name

First name

Grade

Email

Specialty

Function
—Please choose an option—ProfessorUniversity Hospital ProfessorAcademic Manager
Department

Faculty/Institute

II Internship project:
Host institution

Countries

Duration

Guardianship Authorization