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Application - Amgen Scholars Program at ETH Zurich 2016

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Before submitting your application please read the instructions on the How to Apply page.

Personal Information
Salutation*
Ms
Mr

Family name*

First / Given name(s)*

E-mail address*

(Mobile) Phone number (incl. country code)*

Date of birth*
dd.mm.yyyy

Country of nationality*

Students of any nationality can apply.

Country of 2nd nationality

if applicable

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Home country

Country where the majority of your secondary education took place

Your university
The university at which you are enrolled as a regular (degree-seeking) students. If you are currently spending a semester abroad, you should indicate your home
university.

University*

Country*

You must be enrolled as a regular (degree-seeking) student at a university in one of the indicated countries.

Degree programme / Major*

Current year of study*

2nd

3rd

4th

5th or more

Total (nominal) duration of your degree program (years)*

Anticipated graduation year*

The value must be between 2016 and 2020, inclusive.

What is your ultimate degree objective?*

Doctorate/PhD
MD/PhD

Master's (MSc/MA)
MD

Other, please specify

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Address Information

Your current address*

Street, No.
Postcode
City

Country
Your permanent address (if different from current)
Street, No.
Postcode
City

Country

Preferred Host Laboratory / Research Group at ETH Zurich

(see the "Hosting Labs" on the programme homepage)*
Please indicate at least 2 preferences

1st preference

2nd preference
3rd preference

How did you hear about the Amgen Scholars program?

Heard through University website: Specify Heard through Poster Heard through Conference: Specify Heard through Academic Advisor

through Amgen Scholars website at ETH Zurich

through university website
through e-mail

through poster/flyer

through a conference

through Academic Advisor

through Internet search

through faculty or staff from my university

through faculty or staff from another university

Other, please specify

Are you applying to other Amgen Scholars Program sites?*

Yes
No

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Have you participated as an Amgen Scholar in the past?*

Yes
No

Have you participated in research as an Undergraduate (academic year or summer)?*

Yes
No

Additional Information or Comments

In addition to this online application form, you must submit the following documents:
Your CV - please be sure to list any lab skills you may have already acquired and your proficiency in them
(You may use any CV you wish - if you need help, please feel free to use the Europass format.)
Official academic transcript from your home university
Letter of motivation (1-2 pages)
Please send the docouments as PDF attachments by e-mail to amgenscholars@sl.ethz.ch

I agree that my information in this application may be passed on to the Amgen Foundation for statistics and programme
evaluation purposes.*
Yes

No

For questions regarding the Amgen Scholars Program at ETH Zurich, please see the FAQ.

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