To the registration office of the QCCC:

Herewith I register for the PhD programme QCCC.
CV, grades, diplomas, and two confidential letters 
of recommendation will follow separately. 


PERSONAL DATA

Family Name:
First Name:
Gender:
Date of Birth:
Country of Birth:
Nationality:
Marital Status:


ADDRESS

Email Address:
Affiliation:
Street:
Postal Zip Code:
City:
State:
Country:
Phone:
Fax:


EDUCATION

Major Field(s) of Studies:
Title of Thesis:
Grade Point Average (GPA):          out of possible:
College or University:
City:
State:
Country:
Date attended, from:
to:
Degree awarded / expected (when?):
Honours, Scholarships, Prizes, and Awards:

Universities attended earlier (if applicable):


SKILLS

Languages:
Working Experience:


PREFERENCES FOR PHD PROJECT

specify field of interest for PhD project:


FOCUS ON THEORY OR EXPERIMENT

____ mainly experimental?
     ____ preference for quantum dynamics (group Rempe)
     ____ preference for quantum communication (group Weinfurter)
     ____ preference for spin control (group Glaser)
____ mainly theoretical?
     ____ quantum information (group Cirac) 
     ____ quantum control (group Glaser)
(please tag with "X" or give preferences "1,2, ..." where "1" is highest)


REFERENCES

Referee 1:
Name:
Address:
Institution:
Phone:
Fax:
Email:
URL:

Referee 2:
Name:
Address:
Institution:
Phone:
Fax:
Email:
URL:


OTHER / PERSONAL COMMENTS