| I am
applying for Registration finantial support:
I am
applying for Lodging finantial support:
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Family Name:
First Name: |
| Passport/DNI
Institution Full Address Department:
University:
Street and number:
P.O. Box: City:
Postal Code: Country:
Telephone: Fax:
e-mail:
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Personal Address Street name and number:
City:
Postal Code: Country:
Citizenship: Birthdate:
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Gender: Female
Male
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Academic
Record
Date diploma obtained (DD/MM/YY):
(the one that gives you direct access to doctoral studies)
Date doctoral degree obtained (DD/MM/YY):
Number of years of
research experience (full-time equivalent)
since obtaining diploma which
gives you direct access to doctoral studies in the country in which the
diploma was obtained:
Thesis Advisor/Research
Supervisor:
Present Academic Position:
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| Did you remember to tick the
financial support that you are applying for? If not, please, go up to the top of the
form and do it now.
If yes, you are ready to send the form.
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| * Note
that financial support is only available for the whole
conference, including the two workshops. No financial
support is available for participants planning on attending
only part of it.
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CENTRE DE RECERCA MATEMĀTICA
Apartat 50
E-08193 BELLATERRA
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