Please send the form, preferably by e-mail, to

Augusto Micheletti, Secretary of CIRM
Fondazione Bruno Kessler

Via Sommarive, 14 - Povo
I-38100 Trento, Italy
fax: +39-0461-810629
michelet@science.unitn.it

APPLICATION FORM

XXIV International Workshop

on Differential Geometric Methods

in Theoretical Mechanics

Levico Terme (Trento), August 24-30, 2009

 

Family Name:     

First Name:        

Age:                    

Sex:                     

Citizenship:         

Full address:        

                             

e-mail:                  

Present professional position: 

I need financial support:            

Arrival date (standard: Monday, August 24 afternoon/evening):           

Departure date (standard: Sunday, August 30 after breakfast):

I would like to give a short talk:  Yes   No

Title of the short talk:
 

Date:                                                                

Signature