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Workshop on Mathematical Neuroscience

21 March to 23 March 2005, Edinburgh


Scientific Programme & Participants | Workshop Arrangements | Registration Form | Home
PLEASE NOTE - REGISTRATION IS NOW CLOSED

Registration Form

All participants should complete Sections 1 to 3.
Those applying for financial support should complete Section 4
* indicates required field

Section 1

Personal Details

*Last Name
First Name
Title
*Email
*Institution
*Department and Institution's Address
Telephone
Special requirements Please specify any special dietary or other requirements


Section 2

Dates of Attendance

I expect to arrive on
* (day of the week)
* (date i.e. dd/mm/yy)
and leave on
* (day of the week)
* (date i.e. dd/mm/yy) .

Section 3

Workshop Dinner

Please choose one of the following options (there is no additional charge for the Dinner):
I will attend the dinner on Tuesday 22 March

I will not attend the Dinner

Section 4

Request for Financial Support

You may request support only if you are either (a) a PhD student at a UK HEI or (b) if you are employed in a mathematical department in a UK HEI.

Please choose one of the following options:.
I am a PhD student in a UK HEI and wish to apply for a £200 reimbursement against receipts for my accommodation and/or travel. (I understand that I have to pay the £35 registration fee.)

I employed in a UK HEI and wish to apply for a £200 reimbursement against receipts for my accommodation and/or travel. (I understand that I have to pay the £35 registration fee.)

Section 5

I would like to present a poster at the workshop
I would like to give a talk at the workshop
Please give the title of your talk/poster if possible.

Scientific Programme & Participants | Workshop Arrangements | Registration Form | Home
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