Application Form

ECN Exchange Programme Application Form

* Indicates a required field

Personal Information

First Name*

Last Name*

Country of Residence*

Email Address*

Twitter Handle

Nationality*

Year of Birth*

Gender*

Which languages can you communicate in?*

Affiliation & Research Interests:

Which affiliated national obesity association are you a member of?*

Area of specialty:*

Application:

Please identify your first preferred host site to visit from the host list*

Please identify your second preferred host site to visit from the host list*

Please identify your third preferred host site to visit from the host list*

Please describe your current research area of interest (e.g. endocrinology, epidemiology, etc.) (max. 100 words)*

Why are you interested in visiting this research site? (max. 200 words)*

What specific skills do you hope to gain from participating in the ECN Exchange Programme? (max. 200 words)*

Why are you committed to developing your knowledge on obesity? (max. 200 words)*

To participate, applicants must not have any previous or ongoing collaborations with the host site. Please check this box to confirm that you have no previous collaborations.*

To participate, applicants must not have any previous or ongoing collaborations with the host site. Please check this box to confirm that you have no previous collaborations.

Education and Training (most relevant and recent)

Start Year*

End Year

Name of Institution*

Type of Institution (e.g., University):*

Please list the principal subjects or skills covered in your education (max. 200 words):*

Level (National or International Classification):*

Work Experience (most relevant and recent)

Start Year*

End Year

Employer Name*

Employer City*

Employer Country*

Main Activities and Responsibilities (max. 200 words):*

Consent

I consent to EASO processing my personal data for this application
I certify that I meet the ECN Exchange Programme eligibility criteria and am a member of the ECN
I confirm that I will submit a visit report within one month of completing the site visit, and I am willing to participate in a short recorded interview for promotional purposes if requested by EASO.
I agree to receive information from EASO and related projects

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