Application Form for Phase II

SECTION 1 – Personal Information

Name *

Phone

Email Address *

Gender *MaleFemale

Country of Origin *Country of OriginAlgeriaAngolaBeninBotswanaBurkina FasoBurundiCabo VerdeCameroonCentral African RepublicChadComorosCongo, Democratic Republic of theCongo, Republic of theCote d'IvoireDjiboutiEgyptEquatorial GuineaEritreaEswatiniEthiopiaGabonGambiaGhanaGuineaGuinea-BissauKenyaLesothoLiberiaLibyaMadagascarMalawiMaliMauritaniaMauritiusMoroccoMozambiqueNamibiaNigerNigeriaRwandaSao Tome and PrincipeSenegalSeychellesSierra LeoneSomaliaSouth AfricaSouth SudanSudanTanzaniaTogoTunisiaUgandaZambiaZimbabwe

Do you have any Disability *YesNo

Describe the Disability

What kind of support would you need to participate in the mobility

SECTION 2 – Application Details

Level of Education *Bachelors StudentMasters StudentPhd Students

Category being applied for *Category being applied forResearchCredit SeekingInternship/Trainship

Select Program/Course of InterestSelect Program/Course of InterestPhD in Applied Economics, ASU, EthiopiaDoctor of Philosophy in Food Security and Sustainable Development, JOOUST, KenyaDoctor of Philosophy in Innovation and Sustainable Development, JOOUST, KenyaDoctor of Philosophy majoring in Agricultural Economics, UFS, South AfricaDoctor of Philosophy majoring in Agricultural Management, UFS, South AfricaDoctor of Philosophy majoring in Sustainable Agriculture, UFS, South Africa

Select Program/Course of InterestSelect Program/Course of InterestMaster of Agribusiness, MMU, UgandaMaster of science in Agroecology. MMU, UgandaMaster of Natural Resources Management. MMU UgandaInternational Master in Agricultural Management (IMA) ASU, EthiopiaAgricultural Economics, ASU, EthiopiaMaster of Science in Food Security and Sustainable Development , JOOUST, KenyaMaster of Science in Innovation and Sustainable Development, JOOUST, KenyaAgronomic Sciences, USSEIN, SenegalFood Science and Technology Department, USSEIN, SenegalInternational Master in Agricultural Management (IMA), UK, TogoMaster of Science majoring in Agricultural Economics, UFS, South AfricaMaster of Agriculture majoring in Agricultural Management, UFS, South AfricaMaster of Science in Agriculture majoring in Food Science, UFS, South AfricaMaster of Sustainable Agriculture, UFS, South AfricaMaster of Science in Agribusiness and Value Chain Management, ASU, Ethiopia

Select area of interest for Internship Placement *Select area of interest for Internship PlacementAgribusiness farms/processing plantsAgroecology farmLivestock production farmsMixed farms

SECTION 3 – Institutional Information

Institution you are Affliated to *Institution you are Affliated toArsi University, (ASU, Ethiopia)Jaramogi Oginga Odinga University Of Science and Technology (JOOUST, Kenya),Mountains of the Moon University (MMU, Uganda)Universite De Kara (UK, Togo)Universite Du Sine Saloum El-Hadj Ibrahima Niass (USSEIN, Senegal)University Of The Free State (UFS, South Africa)Others

Enter the name of your University

Institution where you are studying (if different from your institution of affiliation)

Attach proof of Affliation to your insititution(e.g Admission Letter, or Employment Letter) *

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Institution You are interested In *Institution You are interested InArsi University, (ASU, Ethiopia)Jaramogi Oginga Odinga University Of Science and Technology (JOOUST, Kenya),Mountains of the Moon University (MMU, Uganda)Universite De Kara (UK, Togo)Universite Du Sine Saloum El-Hadj Ibrahima Niass (USSEIN, Senegal)University Of The Free State (UFS, South Africa)

SECTION 4 – Research & Motivation

5. A motivation letter including how the mobility scholarship relates to their current study program or research (max 500 words) *

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Title of Proposed Research *

Research Concept (Must include planned activities while at the host institution) *

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Upload as a single file: CV (with academic background & relevant work experience), passport bio page, and scanned degree certificates. *

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SECTION 5 – Declaration

I hereby declare that all the information provided is true and accurate to the best of my knowledge. I understand that providing false information may lead to disqualification.

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