logo Preslogo UFCApplication form for admission as a PhD studentt
Year 2012-2013 - Form no.                
Doctorale schoolCPESLETSSPIM

Guidance notes: Once all the documents required by your Doctoral School completed, you have to fill that application form and have it signed by your PhD supervisor and the director of your research unit, before transmitting it to the secretary of your doctoral school with all the required documents, as soon as possible.
Note that some registrations require a long treatment time, when the opinion of the doctoral school council is requested (derogation in case of absence of Master’s degree, sensitive thesis topic which requires the approval of CNRS officials when mixt research units are involved…). Except for few cases, depending on the type of funding, all the registrations have to be signed by the President of the University before the 15 December 2012.
The doctoral school have to attach the following documents to that application form when transmitting it to the President of the University:
- For registration in 1st year: description of the thesis written by the student (objectives, work schedule, methodology, …) as well as the acceptance by the council of the doctoral school in case of derogatory registration;
- For registration in 2nd or 3rd year: summary of the thesis progress written by the PhD student;
- For registration in 4th year or more (derogatory registration to be approved by the council of the doctoral school and the scientific council of the university): detailed report on progress of the thesis written by the PhD student and expected date for the thesis defence. That report has to be signed by the PhD supervisor.

Mrs Miss Mr
Last name 
First name 
Adress: Street   
   Post code City  Country  
 
Date of birth    Birthplace  Nationality 
Email 1    Telephone 1         
Email 2     Telephone 2          
Student Number              
Degree that gives access to undertake doctoral studies (degree full name)   
Year of completion  Country   City 
University

Year of 1st registration in Doctorate (2011-2012 e.g.)    Year of registration : 1s , 2nd , 3d
Derogatory registrations :  1st year with special permission for people without a Master’s Degree ,
4d year or more : specify   

PhD supervisor     
CNU section of your supervisor         
2nd advisor with HDR (not compulsory)      
 Advisor(s) without HDR                    
Doctoral school        
Research Unit  
Structure : UFR SJEPG , SLHS , SMP , ST , STGI , U-Sports , UTBM
Doctorate speciality 
Topic of the thesis 

Cotutelle : yes no
Country  , City , advisor there , university

Is your PhD thesis financed?
« Contrat doctoral » (research grant): financed by (French Ministry of Research, City,... )    , employer  
  CIFRE contract: under project  or signed , employer 
 Paid on a Research Grant : grant  , employer   , duration of your contract  , your post    
 Association or foundation grant : financed by    , amount of the grant  
 Funding for foreigners : financed by   , amount of the grant  
Other funding: specify  
Thesis without  funding
What is your employment situation? 
Employee in the private or public sector : employer   , duration of your contract  , full- or part-time work (in %)  , your post    
 Teacher of the French Ministry of National Education : specify  
 Teacher abroad : specify  
 Retired person
 Unemployed student 
Other situation: specify   

I,   (LAST NAM, first name), confirm the acceptance of the statements of the Charter of Theses (available on the website of the doctoral school) and that the information I have provided on this application form is true, accurate, current and complete to the best of my knowledge.
Locality   , date       Signature of the candidate:

PhD supervisor (1)

Opinion
Date
Name
Signature
Research unit director (2)  

Opinion
Date
Name
Signature
Doctoral school director   (3)

Opinion
Date
Name
Signature
  President of the University (4)

Decision
Date

Signature