Applicant’s name:
Department / Workplace:
Study branch:
According to Article 6 paragraph 9 of the Doctoral Study Code at the Faculty of Electrical Engineering CTU in Prague I hereby ask for
recognition of .... credits received for an internship at a research workplace abroad.
Name and address of reasearch workplace:

Date of internship from:			to:	

A report on the internship in the length of app. 1 A4 page containing the name of the host abroad, his or her personal website, a description of work activities, an assessment of internship merit and effect on knowledge, publishing activity and on the degree of completion of the student‘s doctoral thesis; alternatively, other statements are on a separate attachment of this application. 

At the same time, I request/do not request that my study be interrupted
as of:				to:

Signature of doctoral student:

Supervisor’s statement and signature:

Department Head’s statement and signature:

Branch Board chairman’s statement and signature:

Report on the internship

•	name of the host abroad and a link to his or her personal website,
•	work activity description,
•	assessment of the merit and effect of the internship on doctoral student’s knowledge,
•	publishing activity and the degree of completion of student’s  doctoral thesis,
•	other statements.