Algebraic and Geometric Combinatorics

August 20-26, 2005

Application Form

Name:

Date and place of birth:

Nationality:

Gender:

Current position:

e-mail address:

Postal address:

Research field:

If you wish to give a talk, please give a tentative title.

Do you wish to apply for financial support?
For living expenses: YES / NO
For travel expenses: YES / NO (please give estimated cost of tickets in euros)
For refund of the registration fee: YES / NO

Please give the following information:

1. List which of the following degrees you hold, the University and the date awarded.