Augusto Micheletti, Secretary of CIRM
Istituto Trentino di Cultura
I- 38050 POVO (Trento), Italy
fax: Italy+0461 810629
michelet@science.unitn.it
Application Form for financial support
I wish to apply for a grant to attend the event "Eager 2002 Advanced School in Algebraic Geometry", taking place in Levico Terme (Trento), May 14-19, 2002.
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