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

Augusto Micheletti, Secretary of CIRM
Fondazione Bruno Kessler

Via Sommarive, 14 - Povo
I-38123 Trento, Italy
fax: +39-0461-810629
michelet@science.unitn.it

APPLICATION FORM

International Summer School on “Mathematical Fluid Dynamics”

Levico Terme (Trento), June 27th – July 2nd, 2010

 

Family Name:     

First Name:        

Age:                     

Sex:                     

Citizenship:         

Full address:        

                            

e-mail:                  

Present professional position: 

I need financial support:            

Arrival date (standard: Sunday, June 27 afternoon/evening):           

Departure date (standard: Friday, July 2 after lunch):

 

I would like to give a short communication: Yes/No

Title:

Short abstract:

 

Date:                                                                

Signature