Nomination Incoming WISSENSCHAFTLICH-TECHNISCHE ZUSAMMENARBEIT (WTZ) SCIENTIFIC & TECHNOLOGICAL COOPERATION Cooperation country: Project number in Austria: 1. Personal data guest researcher Surname: name: Academic degree: Date of birth: Sex: male female Research institution in the home country: Address of home institution: Contact: E-Mail: 2. Information Visit to Austria – Date of visit in Austria: from to Duration of stay: day(s) month(s) total: 3. Information - Austrian project partner Research institution in Austria: Address of host institution: Name of the project coordinator in Austria: Contact: Telephone: E-Mail: 4. Reimbursement of accommodation expenses: (please choose) Bank transfer to the following Austrian bank account at our local OeAD Regional Office to the (Acknowledgement of receipt signed by the visiting guest researcher personally: researcher to be send to the OeAD-GmbH / ICM) Name of bank: BIC: IBAN: Account holder: Internal assignment number: (university project accounts ONLY) Purpose: (if required) Please submit this nomination to the OeAD-GmbH / ICM Ebendorferstraße 7, 1010 Wien or per fax: 01/53 408-499 or e-mail: 3 weeks prior to your guest researcher’s stay. , Place Date Signature Version 20.01.2015, M. Staltner (OeAD/ICM/WTZ)
Nomination Incoming WISSENSCHAFTLICH-TECHNISCHE ZUSAMMENARBEIT (WTZ) SCIENTIFIC & TECHNOLOGICAL COOPERATION Cooperation country: Project number in Austria: 1. Personal data guest researcher Surname: name: Academic degree: Date of birth: Sex: male female Research institution in the home country: Address of home institution: Contact: E-Mail: 2. Information – Visit to Austria Date of visit in Austria: from to Duration of stay: day(s) month(s) total: 3. Information - Austrian project partner Research institution in Austria: Address of host institution: Name of the project coordinator in Austria: Contact: Telephone: E-Mail: 4. Reimbursement of accommodation expenses: (please choose) at our local OeAD Regional Office to the guest researcher personally: Bank transfer to the following Austrian bank account (Acknowledgement of receipt signed by the visiting researcher to be send to the OeAD-GmbH / ICM) Name of bank: BIC: IBAN: Account holder: Internal assignment number: (university project accounts ONLY) Purpose: (if required) Please submit this nomination to the OeAD-GmbH / ICM Ebendorferstraße 7, 1010 Wien or per fax: 01/53 408-499 or e-mail: 3 weeks prior to your guest researcher’s stay. , Place Date Signature Version 20.01.2015, M. Staltner (OeAD/ICM/WTZ)
Nomination_Incoming.docx