Augusto Micheletti, Secretary of CIRM
Istituto Trentino di Cultura
I- 38050 POVO (Trento), Italy
fax: Italy+0461 810629
michelet@science.unitn.it

I wish to apply for a grant to attend the event "Eager 2001 advanced school in Algebraic Geometry", taking place in Levico Terme (Trento), 1-5 settembre 2001.

Surname

First name

Age

Nationality

Professional status

University/ Company (with address, tel. and fax)

First university graduation

Discipline

Institut of graduation

Brief curriculum vitae since graduation:
 
 
 
 
 
 

Current of projected research activities and motives for wishing to attend the Summer school
 
 
 

Do you or your research group hold a grant from which the participation in the event could be funded?

Have you applied for a grant for this purpose from any other body?

If yes, what result?

Scientific publications of applicant (no more than 5, your best or more recent; give title of paper, volume and page numbers, authors)
 
 
 
 
 
 
 
 
 
 

Estimated cost in ITL of travel to the event (using most economical air or second class train fare)
 
 

I declare the above truthful and sincere. I do not expect to be funded for participation in the event from other sources except as above, and that if awarded a grant by the organisers of the event, I will not cover any expenses from more than one funding source.

Signed
 
 

Date
 
 

(Optional)

Comments on benefit of participation from supervisor, Department Head, etc.)

Name
 
 

Institution
 
 

Position

Relation with applicant

Comments
 
 
 
 
 
 

Signature