Internship Funding Application If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Funding Program * You can apply only for one funding program at a time. ERASMUS+ (EU funding program) New York University of Medicine Travel Grant Last Name * First Name * Email * Class * Major * Applied and Computational Mathematics Biochemistry and Cell Biology Bioinformatics and Computational Biology Biology/Neuroscience Biotechnology Chemistry Computer Science Earth and Environmental Sciences Earth and Space Sciences Electrical and Computer Engineering Electrical Engineering and Computer Science Global Economics and Management Industrial Engineering and Management Information Management and Systems Integrated Cultural Studies Integrated Social and Cognitive Psychology Integrated Social Sciences Intelligent Mobile Systems Intercultural Relations and Behavior International Business Administration International Relations: Politics and History International Politics and History International Logistics Management and Engineering Integrated Environmental Studies Mathematics Medicinal Chemistry and Chemical Biology Physics Psychology MSc International Logistics: Management and Engineering Global Humanities Cognitive Psychology and Neuroscience OTHER Matriculation Number * Cumulative GPA * Internship Institution * Country Belgium Bulgaria Czech Republic Denmark Germany Ireland Greenland Spain France Croatia Italy Cyprus Latvia Lithuania Luxembourg Hungary Malta Netherlands Austria Poland Portugal Romania Slovenia Slovakia Finland Sweden United Kingdom The former Yugoslavia Iceland Norway Republic of Macedonia Liechtenstein Turkey United States City * Please fill in the city where your internship will take place. From * Please indicate the starting date of the internship. To * Please indicate the ending date of the internship. Does the internship take place in your home country? * yes no Personal Statement * Tell us why you chose this speciﬁc internship and how it ﬁts into your career plans, why you could not ﬁnd a compensated internship or other sources of support, and why Jacobs University should provide you with internship funding for this speciﬁc internship. Internship Institution Details: * Please provide a short description (500 characters) of the internship institution, the department/lab you will be working and the project you will be involved in. Internship Support: * Please indicate what support the internship host institution provides during your internship (e.g. housing, food, salary, transportation, etc.). If this is a paid internship please indicate the amount of payment per month. Please indicate the bank and account details to which we need to transfer the money should your application be successful. This information will be kept strictly confidential and only Career Services and Accounting will have access to it. Bank: * IBAN: * BIC CODE (Optional for bank accounts outside of Germany) Account holder: * Conditions * I understand that the stipend applies only for the internship stated in this webform and it is not transferrable to another internship, or the same internship of a different duration. In any of the following cases, the funding will have to be returned to Jacobs University: If I do not complete the above stated internship; If my internship is shorter than the duration mentioned in this funding application; If I decide to participate in an internship other than the one stated on this internship; If, after my internship, I leave Jacobs University without graduating. I agree to the conditions stated above. If you have any further questions, please contact the CSC-Team.