APPLICATION-FORM-

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					                          EUA4X E-Atelier

                      APPLICATION FORM

Please fill this form and send it to: eua4x.e.atelier@gmail.com
Please note that before you fill in the form make sure you meet the EC
requirements. Eligibility information which helps you to determine whether
you may register can be found at: http://www.eua4x.net under “Atelier”.
I would like to     Event title: (eg. “EUA4X#12 - EUA4X#12 CFD HIGHER
subscribe to the    ORDER DISCRETIZATION METHODS)
virtual event:
Name:
Surname:
Birth date:

Gender:
City:
Nationality:

                             AFFILIATION
Institution Name:
Address:
City:
Postal Code:
State/Country:
email:
Date of Diploma
(Start-End date):
Date of PhD:
According to the       GROUP 1-Early stage researchers
eligibility criteria
I belong to:           GROUP 2 -Experienced researchers

                       GROUP 3 -Experienced researchers

Please, write in less than 2000 characters, your research topics, as well as your
motivation to attend the online courses




According to the Italian law D.lgs. n. 196/2003 art. 13 (before art. 10 law
675/1996) in defence of privacy, we inform that your personal data will be used
exclusively by TCN Scarl. in the frame of the EUA4X Project’ activities. Any
other use will require your explicit authorization. For more information or any
inquiries please contact the project’ coordinator, Giorgio Fotia: gfotia@crs4.it

				
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posted:3/2/2010
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Description: APPLICATION-FORM-