Contact
Adriana Hołub-PalonkaCzapskich 4, room 26
tel. +48 12 663 3015
adriana.holub-palonka@uj.edu.pl
NOTE: This is not an application form to fill out. This is just an instruction on how to plan your fellowship budget. Instruction in Polish is available on the Polish-language version of this Web page.
First and second (family) name
Receiving institution
Planned duration of your visit
1. Tuition and university fees, including participation in classes, workshops, etc. (specify the amounts) |
||
a) ............. | $ ............. | |
b) ............. | $ ............. | |
c) ............. | $ ............. | |
Total: | $ ............. | |
2. Research costs (specify objectives and amounts) |
||
a) ............. | $ ............. | |
b) ............. | $ ............. | |
c) ............. | $ ............. | |
Total: | $ ............. | |
3. Book purchases, photocopying costs (additional information is irrelevant) |
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a) purchase of books, data bases, audiovisual materials | $ ............. | |
b) photocopying costs | $ ............. | |
Total: | $ ............. | |
4. Travel costs |
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a) tickets, (specify itineraries, means of transport, ticket prices) - ................. - ................. - ................. |
$ ............. |
|
b) passport fees | $ ............. | |
c) visa cost (specify country) | $ ............. | |
d) insurance (specify cost) | $ ............. | |
Total: | $ ............. | |
5. Accommodation and living costs (specify place, number of weeks/months x amount) |
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a) accommodation | ....weeks/months x $.... | $ ............. |
b) food | ....weeks/months x $.... | $ ............. |
c) public transport | ....weeks/months x $.... | $ ............. |
Total: | $ ............. | |
6. Other costs, if applicable (specify) |
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a) (eg., sending books to Poland) | $ ............. | |
b) ............. | $ ............. | |
c) ............. | $ ............. | |
Total: | $ ............. | |
Grand total: | $ ............. |