Superconductivity Winter School
8 - 12 January 2007
APPLICATION FORM
Title: Dr / Mr / Mrs / Ms / Miss Surname:
Initials: First Name:
Research Institution:
Address:
Post Code
Telephone: E-mail:
Status: (Research Student Year: 1, 2, 3, or other)
Research Supervisor’s Name: (in block letters)
I confirm the above details and support the
application: (Supervisor’s Signature)
Area of Research Interests:
Costs: (Please tick appropriate box)
EPSRC Supported Student: £80.00
Non EPSRC Student:
Fee £80.00
Accommodation: (B&B/Evening Meals/Conference Dinner) £201.00
Lunches and Refreshments £25.00
Conference Dinner £30.00
Total Payment: £306.00
I confirm that the appropriate fees will be paid immediately on receipt of confirmation of a place on the
course.
Signature.........................................................……… Date: …………………………
Please return this form as soon as possible, and by 20 November at the latest, to:
Mrs Alicia Kelleher, Cavendish Laboratory, University of Cambridge, J J Thomson Avenue,
Cambridge, CB3 OHE; Fax: 01223 350266; Tel: 01223–337336; E-mail: apk21@.cam.ac.uk
(Please photocopy this form as necessary for use by colleagues)