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* 1. First Name

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* 2. Last Name

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* 3. Gender

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* 4. Email address

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* 5. What is your Nationality? (Limited to African or European nationals only)

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* 6. Are you an African diaspora in Europe?

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* 7. Are you currently based in Europe or Africa?

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* 8. Date of Birth

Date
Academic Information

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* 9. What is the name of your university or institution?

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* 10. PhD / Post-Doctoral Programme / Field of Study

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* 11. What is your current year in the PhD program?

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* 12. Which country are you pursuing your PhD in, or did you complete your PhD programme?

Research & Motivation

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* 13. Research Abstract (200 words max)

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* 14. Statement of Commitment to Africa-Europe collaboration (how do you plan to
contribute with research background?) – (200 words max)

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* 15. Potential impact of your research on local communities and wider society (200
words max)

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* 16. How does your academic research align with the AU-EU Innovation
Agenda and the short-, medium-, and long-term actions under Capacities for
Science under the Agenda (200 words max)

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* 17. Describe any experience you have in cross-continental collaboration

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* 18. Upload CV/Resume

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* 19. Additional Comments

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