A P P L I C A T I O N     F O R M  

Instructions:  

Please, complete the form, including the names of the referees and click on "apply now".  Prospective participants are expected to stay throughout the duration of the summer school, and give a presentation on their prior work.  There will be two afternoons allocated for 15 minute oral presentations.  Poster boards will be available through the duration of the summer school.  

Living expenses of the participants will be covered by a grant for all 10 days.  A limited number of travel fellowships will be offered to selected participants.  Therefore, please, indicate whether support from the ASI is critical for your attendance.

 

Please contact giedrius@salk.edu if you cannot see in the browser the "apply now" button or are getting error messages.

Last name:

First name:

Email address:

Age:   Gender:    
Nationality:
Address:        City:
State:   Zip:  Country:
Phone:
Fax:
Academic degree and when obtained:
Name of educational institution:
Field in which degree is obtained:

The two referrence letters will be provided by (name, affiliation, e-mail address):

1 .

2.

Professional activity since last degree:
Relevant publications (if any):
Employer: Current position:   
Will you stay for the whole duration of the institute?       
Accompanying persons: Spouse  Number of children      
Does your attendance depend on grant?  

If yes, indicate support needed for travel: 

Method of presentation: oral   poster   none.
Please give title and abstract (200 words) below:

 


last updated on 02.24.2000