CANDIDATURA

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

CANDIDATURA

Preenche este formulário para participar do concurso

Identidade / Identité / Identity

Nome / Prénom / Firstname *

Sobrenome / Nom de famille / Lastname *

Data de nascimento / Date de naissance / Date of birth *

YYYY

Nacionalidade / Nationalité / Nationality *

Sua pesquisa / Ta recherche / Your research

Você é / Tu es / You are *

Mestrando / Étudiant en master / Master

Doutorando / Doctorant / PhD student

Pós-doutorando / Post-doc

Pesquisador / Chercheur / Researcher

Other:

Instituição(ões) de ensino superior ou de pesquisa onde você está matriculado / Institution(s) d'enseignement supérieur ou de recherche où tu es inscrit / Higher éducation or research institution(s) where you are enrolled *

Adicionar o nome da cidade e do estado / Ajouter le nom de la ville et de l'Etat / Add the name of the city and the state

Se não estiver matriculado em uma instituição brasileira, quais são as datas da sua estada no Brasil ? / Si tu n'es pas inscrit dans une institution brésilienne, quelles sont tes dates de séjour au Brésil ? / If you are not enrolled in a Brazilian institution, what are the dates of your stay in Brazil?

Os candidatos matriculados em uma instituição de ensino superior ou de pesquisa européia são elegiveis somente se moram no Brasil durante o périodo de abertura do concurso (01/05/2015 - 25/09/2015) // Les candidats rattachés à un établissement d’enseignement supérieur ou organisme de recherche européens sont éligibles sous réserve de séjourner au Brésil durant la période d’ouverture du concours (01/05/2015 - 25/09/2015) // The candidates enrolled in a higher education or research European institution are eligible only if they are living in Brasil during the opening phase of the competition (01/05/2015 - 25/09/2015)

Laboratório / Laboratoire / Laboratory

Tema da pesquisa que será apresentado no concurso / Sujet de recherche qui sera présenté dans le concours / Research subject which will be presented in the competition *

Disciplina / Discipline *

Contato / Contact

Email *

Telefone / Téléphone / Phone *

Colocar o indicativo do pais e o DDD / Mettre l'indicatif du pays et de la ville / Put

Você mora no Brasil ? / Vis-tu au Brésil ? / Do you live in Brazil ? *

Sim / Oui / Yes

Não / Non / No

Cidade onde você estará no momento da final / Ville où tu seras au moment de la finale / City where you will be at the date of the final *

Os seus trechos internos no Brasil ida e volta para participar da final no Rio de Janeiro (25/09/2015) serão cobertos pelos organizadores / Les trajets internes au Brésil aller-retour pour participer à la finale à Rio de Janeiro (25/09/2015) seront pris en charge par les organisateurs. / Your return journeys in Brazil to join the finals in Rio de Janeiro (25/09/2015) will be covered by the organizers.

Intellectual property and image rights

Please, tick the following boxes: *

I read and accepted the terms and conditions available here: http://bit.ly/termos_minha_pesquisa_sobre_clima

I declare that I hold the intellectual property rights to the research presented

I autorize the organizers to use my candidacy video and eventual pictures and videos recorded in the context of the competition for promotional activities

I agree to support the organizers with the production of further promotional material (which may include photography, filming or interviews) in the context of the competition as they may reasonably require.

Required

Sua candidatura / Ta candidature / Your application

Vídeo apresentando a sua pesquisa *

Idioma do seu vídeo / Langue de la vidéo / Language of the video *

Name of the file sent by email or Link to your online video *

The file was sent on

YYYY

Organizadores

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms