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Faculty of Social and Behavioural Sciences, Utrecht University
Graduate School of Social and Behavioural Sciences
PhD Office
Allowance for the costs of printing the doctoral thesis
Initials + surname:
*
Address (street + nr.):
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Postal code:
*
Town/City:
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Country:
*
Email:
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Do you have an IBAN number (inside EU)?
*
Yes
No
IBAN nr.:
*
In the name of (please put down the ascription exactly as shown on your bank account statement):
*
Bank account number:
*
In the name of (please put down the ascription exactly as shown on your bank account statement):
*
Bank code(s) (Bank code(s) may differ, e.g. ABA-Routing for US, CAD-number for Canada):
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SWIFT / BIC code:
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Bank Name:
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Bank Address:
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Town/City + County of the Bank:
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Please note that the requested amount may not exceed the actual printing costs on the invoice!
Requested amount (
up to a maximum of € 750.00
):
*
Date of PhD ceremony
:
*
dd/mm/yyyy
If you have received external funding for the printing costs of your thesis, please indicate the amount you have received:
The undersigned declares that
The candidate's thesis has been approved by the supervisor and the assessment committee;
The candidate has examined and agrees with the
Regulations
for the allowance for the costs of printing the doctoral thesis, as drawn up in July 2021;
The candidate has incurred expenses for the production costs of the thesis. Evidence of these expenses (invoice and bank statement) has been enclosed;
and requests to be considered for the faculty printing allowance of a maximum of € 750.00.
Please, upload the printer’s invoice.
*
Please, upload your bank statement.
*
Your bank statement will be checked by the PhD Office only. After the check, the PhD Office will delete your bank statement, so it won't be added to our administration.
I agree to these regulations
*
Place:
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Date:
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dd/mm/yyyy
*
=
Input is required
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