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APPLICATION FOR ADMISSION TO

THIRD-CYCLE (POSTGRADUATE) STUDIES

Reg. No.

Personal data (to be completed by the applicant)Civic registration number/Date of birth Gender

Female Male

Surname First name(s)

Home address c/o

Postal/zip code Postal address/City Telephone

E-mail Present affiliation, if any, with other university, please specify which*

Information about basic degree/higher education (to be completed by the applicant)Degree/certificate/diploma Date

University Country

Studies intended by the application (to be completed by the applicant)Subject First term

Intended degree

PhD Licentiate Change of subject

Date Signature

BESLUT

To be completed by the departmentAntas till utbildning p forskarniv i mnet Fr.o.m. (datum)

Fakultet Institution

Antagningen syftar till

Doktorsexamen Licentiatexamen Doktorsexamen (senare del)

Avsedd frled i examensbenmning (om alternativ finns)

Huvudhandledare Institution Titel

Bitr. handledare Institution Titel

Anskan avsls

P fakultetsnmndens vgnar

Beslutsdatum Underskrift Namnfrtydligande

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