|
Registration FormAll 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 DinnerPlease 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.
|
|
|
