European University Institute
Application form for vacant chairs
		Chair in Econometrics (ECO1)
Deadline for receipt of applications: 15 September 2006
			
Please type or write clearly with block capitals

Personal details
Family name	First name	
		
Title (Dr. etc.)	Sex	Nationality	Date of birth (dd/mm/yy)	
	  F            M			
Knowledge of languages (please specify active (A), passive (P))	
	
Address for correspondence	

(Institution):

Street:

Postcode:

City:

Country:

E-mail:

Telephone:

Fax:

Professional details
Main current position	Main institution details (name and location)	
		
Other current positions	Institution details (name and location)	
1.	1.	
2.	2.	

Application details
Please list 3 to 5 of your publications most relevant to the post (include publisher and date)	
1.	
2.	
3.	
4.	
5.	
Title of research proposal (please supply full text in annex)	

Referee details
	Referee 1	Referee 2	Referee 3	Referee 4	
Name					
Position					
Institution					

Address

					
E-mail					
Telephone					
Fax					

I certify that the above particulars are complete and accurate	
Date and signature	

In order to improve our publicity for professorial vacancies, we would be grateful if you would indicate where you found the announcement advertising this chair. Thank you.