Applicant name: ..……………………………………………………………………………...……………….……..….…
Supervisor: ..………………………………………………………………………………………………..…….……………
Doctoral study program/branch:    ………………………….………………………………………………….……
 
I hereby apply for a scholarship for Students in the English Doctoral Study Programme for academic year 20…/… in accordance with Art. 4 para 2 point e) of the Bursary Code of the CTU in Prague.

Applicant’s Sworn Declaration
I hereby declare that I have received the Dean’s Decision of Admission to study in the above mentioned doctoral study program, and that my financial situation will not allow me to cover the doctoral study fees at FEE in a foreign language, and that I do not have any outside faculty funding to cover the fee.
In the case that I am awarded a scholarhip, I agree with its internal settlement against the faculty’s balance on my study fees in the amount listed above for the given year.  
I declare that all of the above written details are true, and that I have not withheld any information which could affect the decision to award the special-purpose scholarship.

Date and applicant’s signature:  	………………………………………………………………………………….……

Supervisor’s Sworn Declaration
I hereby declare that I do not have any dedicated source to cover the study fees.
Supervisor’s signature: ……………..……………  Mandator’s signature: ……..…………………………….……
Dept. Head’s signature: ……………….…………  Chairperson of Branch Board’s signature: ……..……… 

Dean’s Decision
I award/I do not award for the reason :
 …………………………………………………………………………………...………….……..…………………………………….
Information
The applicant may request in writing a review of the decision within 30 days from its receipt in accordance of the Bursary Code of CTU in Prague Art. 11 para 6-8. The request is addressed to the Rector of CTU via the Dean of FEE. The Rector’s decision is final.

Date:
                                                       	prof. Mgr. Petr Páta, Ph.D.
 Dean of the Faculty of Electrical Engineering at CTU