PERSONAL INFORMATION	First name(s) and Surname(s)	
	
 	 House number, street name, city, postcode, country 	
	 Telephone number     Mobile number       	
	 e-mail address 	
	personal website(s)  	
		
	| Date of birth dd/mm/yyyy | 
Nationality Enter nationality/-ies 
Gender Enter sex	

CURRENT AND PAST POSTIONS 	 	
[Add separate entries for each experience. Start from the most recent.]
Dates (from - to)	Occupation or position held	
	Employer’s name and locality (if relevant, full address and website)	
	•	S&T field(s) or business sector type of research field(s) or business sector
•	Main activities and responsibilities (up to five lines for each)

EDUCATION AND TRAINING	 	
[Add separate entries for each course. Start from the most recent.]
Replace with dates (from - to)	Qualification awarded		
	Education and training, organisation’s name and locality, country 	
	•	List of principal subjects covered or skills acquired if applicable	
PROFILE/COMPETENCIES	 	
Remove headings not relevant in the left column (for example if you are not an active scientist).

Science and Technology field(s0 and sub-field(s) 

S&T field and sub-field(s)

Scope of research - Key words 

Publications

Projects

Honours and awards

Detail S&T field(s) and sub-field(s) following the OECD classification (in Annex)

•	
1.	

Please, add five key words to describe the scope of your current research

•	Your five most important peer reviewed publications
1.	…
2.	… 
3.	…
4.	…
5.	…
•	The list of publication of the past three years
1.	…
2.	…
3.	…
4.	…
5.	…

•	Your five most important projects
1.	…
2.	…
3.	…
4.	…
5.	…
•	List of your current projects 
1.	…
2.	…
3.	…
4.	…
5.	…

•		

.  Remove headings not relevant in the left column 

Evaluation procedures

Evaluation of research programmes
	Describe your experience with evaluation and selection procedures, mention the most important experiences you participated in the past five years, preferably at European but also international level
Example of an evaluation procedure:
•	Evaluator of proposals in H2020-ICT-2014-1 (ICT9 Tools & Methods for Software Development)
▪	Evaluator of national funding programmes …
▪	Observer 

Describe your experience with thee evaluation of research programmes.

Broad comprehension of S&T, R&D strategies 
Broad comprehension of foresight  	Describe convincingly your comprehension of S&T, R&D strategies and/or foresight at national or European level, list the most important publications, studies, reports, active contributions and/or other relevant examples in the past five years. Remove headings not relevant in the left column.
Example of a broad comprehension of Science and Technology, Research and Development strategies:
▪	Member of the Science and Technology Advisory Council of the EC
▪	Member of the national Advisory council for science, technology and innovation
▪	Working as an expert for the Office of Research Strategy and Development in …
▪	…
Example of a broad comprehension of foresight:
▪	Member of the European high-level foresight expert group on "The World in 2025", the final report published at: http://ec.europa.eu/research/social-sciences/pdf/the-world-in-2025-report_en.pdf
▪	…	

Knowledge in impact analysis	Describe your knowledge in impact analysis, list the five most outstanding publications, studies, reports, active contributions and/or other relevant examples in the past five years. Remove headings not relevant in the left column.
Example of knowledge in impact analysis:
▪	Co-author of Peer Review Impact Analysis Report (Analysis of 14 transnational European Peer Reviews carried out in eight European countries 2006-2009), http://www.oph.fi/download/130480_Peer_Review_Impact_Analysis_Report_10_11_29_final.pdf
▪	…	

Annex: List of Fields and Sub-Fields of Science

Natural Sciences	
Mathematics (research on methodologies of pure and applied mathematics, statistics and probability: mathematics and statistics applied to other fields of science are excluded)	
Computer and Information Sciences	
Physical Sciences (excluding engineering and nano-technology applications to be found under each engineering category)	
Chemical sciences	
Earth and related Environmental sciences	
Biological sciences (excluding medical, clinical and agricultural applications)	
Engineering and technology	
Civil engineering	
Electrical engineering, electronic engineering, Information engineering	
Mechanical engineering	
Chemical engineering	
Materials engineering	
Medical engineering (excluding biomaterials and physical characteristics of living material as 
related to medical implants, devices, sensors)	
Environmental engineering (excluding environmental biotechnology)	
Environmental biotechnology	
Industrial biotechnology	
Nano-technology	
Other  engineering and technologies	
Medical and Health Sciences	
Basic medicine	
Clinical medicine	
Health Sciences	
Medical biotechnology	
Other medical sciences	
Agricultural sciences	
Agriculture, Forestry, and Fisheries (excluding agricultural biotechnology)	
Animal and dairy science (excluding animal biotechnology)	
Veterinary science	
Agricultural biotechnology	
Other agricultural sciences	
Social Sciences	
Psychology	
Economics and business	
Educational sciences (excluding institutional and economic aspects)	
Sociology	
Law	
Political Science	
Social and economic geography	
Media and communications	
Other social  sciences	
Humanities	
History and Archeology	
Languages and literature	
Philosophy, Ethics and Religion (excluding philosophy and ethics applied to other fields of science)	
Arts (arts, history of arts, performing arts, music)	
Other humanities