PRIMA SUMMER SCHOOL APPLICATION FORM
(4 JUN – 29 JUN 2007 )This form should be completed and returned to: Institute for Mathematical Sciences, 3 Prince George’s Park, Singapore 118402or fax to: (65) 6873 8292by 31 March 2007.
*Please indicate as appropriate
** Please delete as appropriate.
1.APPLICATION REQUIREMENTS
(a) A copy of your Curriculum Vitae.(b)2 letters of recommendation to be sent directly to us at Institute for Mathematical Sciences, 3 Prince George’s Park, Singapore 118402.
(c) Optional: A one-page abstract of a 50 minuteoral presentation which is related to the theme of the Summer School.
2.PERSONAL PARTICULARS
Title and Full Name as in Passport/Identity Card (underline Surname/Family Name): / Designation:Mr / Mrs/ Ms **
Institution Name & Address: / Contact Details (# required fields)
Office / Mobile
Home : / Fax No. #
Email # :
Postal Address: (if different from above address): / Nationality:
Passport No.: / Date of Issue:
Place of Issue: / Date of Expiry :
Date of Birth: / Country of Birth: / Sex*: Male Female
3.Please completethis section, if you are applying for Financial Support.
a) Please select the period of activities that you will be attending*:Tutorials only(4 - 22 Jun 2007)
Tutorials & Conference (4 - 29 Jun 2007)
b) Please indicate the type(s) of local financial support required from the Institute* :
On-Campus Accommodation Allowance
c) Have you applied or been granted financial support from other sources for your visit* :
Yes No
If yes, please provide details:
d) If your application for Financial Support is unsuccessful, would you be interested to attend the Summer School*:
Yes No
Please note that successful applicant for financial support on accommodation will be placed at campus-accommodation as allocated by the Institute.
Note: /
- We will process your application (after receiving the above documents) and you will be informed of the outcome by email or post once a decision has been made.
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