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Campus Diepenbeek, Agoralaan - gebouw D B - 3590 Diepenbeek Telefoon +32 11 26 80 10 Telefax +32 11 26 80 19 e-mail: jobs@uhasselt.be www.uhasselt.be Application form for vacancies of Academic Staff Vacancy number for which you are applying:       Surname/familyname:       First name:       Mailing address: street and number: postal code and city: telephone/mobile number:                   Domicile: street and number: postal code and city: telephone/mobile number:                         Place of birth :       Email address: Date of birth:       Male: Female: Nationality:       *2 Acade