COST is supported by the EU Framework Programme Horizon 2020
2nd MemoCIS Training School, 7-9 May, 2016, Alghero, Italy
APPLICATION FORM
Name:
Gender: Male Female
Nationality: Date and place of birth:
Institution name:
Institution address:
Employment status (student/professor/post doctoral fellow/engineer):
E-mail:
I would like to apply for financial support: Yes No
I would like to present a poster: Yes No (students are required to present a poster)
Tentative title:
ACCOMMODATION
Which nights will you require accommodation?: 7 10
FINANCIAL SUPPORT
If you are applying for financial support:
1. Status:
Ph.D. student
Obtained Ph.D. after October 2001
Non of the above
2. Research Area:
3. Name and affiliation of academic supervisor:
Please send this application form and your curriculum vitae/resume (max. 3 page) to:
May
8 (Choose a max of 4 nights if you will attend all 3 days)
6
Surname:
9