IOCCG Summer Lecture Series 2016
Application Form
Villefranche-sur-Mer, France 18 – 30 July 2016
Personal Details
Title (Dr/Mr/Ms/Mrs):____ First name: ______Last name: ______
Age: ____ Gender: Male: ___ Female: ___
Current Residential Address:______
Town: ______Postal/Zip code: ______Country: ______
Country of birth: ______Nationality: ______
Email (personal):______Home telephone: (_____) ______
Current Professional/Academic Affiliation
Institute Name: ______
Institute Address: ______
Town: ______Postal/Zip code: ______Country: ______
Email (professional):______Work telephone: (_____) ______
Course Fee
There is no fee to attend the lecture series but students are encouraged to seek financial support to supplement their travel and living expenses. The LOV laboratory will provide free accommodation (shared rooms/dormitories) for all students, as well as breakfast and lunch on week days. A limited number of scholarships will be available to help defray other expenses (flights, meals), but there will be a limited number of spaces available for scholarship students.
Scholarships
§ Would you like to apply for a scholarship to attend the course? ___
§ Would you like to apply for free shared accommodation at the LOV lab: ___
§ Can you still attend the course if you do not obtain a scholarship?______
§ Will you require a visa to enter France? ______
§ Estimate of a return economy flight from home country to Nice, France (in $US) $______
Academic Information
Undergraduate degree: ______University:______Year graduated:______
Post-graduate degree (1): ______University:______Year graduated:______
Post-graduate degree (2): ______University:______Year graduated:______
Current position/degree: ______
Current area of research: ______
Language skills
Mother tongue: ______
Are you fluent in English? ______
Computer skills
Do you own a laptop computer that you can bring along to the course? ______
Do you have experience with any of the following (select all that apply)?
Linux: ___ SeaDAS: ___ Beam: ___ IDL: ___ MATLAB: ___ ENVI: ___ ODESA: ___ R: ___
Other (specify): ______
Motivation
Describe your motivation to participate to this course and the suitability of your background, including experience with using satellite data and previous relevant training courses attended. Please also outline your area of interest/speciality and what you hope to learn from the course.
Brief Curriculum Vitae (no longer than one page)
Further information
Any additional information you think we might find useful such as publications, thesis topic.
Reference/Supervisor
Name: ______Position: ______
Institute: ______Email: ______
If selected, I hereby declare that I will attend the FULL lecture series: YES/NO ______
I certify that the information in this form is true and correct: YES/NO ______Date: ______
Submission:
Save the completed application form in the following format: Lastname-Firstname-2016-SLS.pdf (or docx) and submit the file via email to: Elizabeth Gross () with a copy to:
• Venetia Stuart () and
• David Antoine () and
Note: It is not necessary to physically sign the form - just submit the completed document via email.
Application Deadline: 15 March 2016 (Strictly enforced)
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