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- UNESCO Regional Bureau for Science in Europe -
- Georgian Academy of Sciences - Tbilisi State University -
Physics at the future colliders
October 16-21, 2005, Tbilisi, Georgia
Registration Form
Deadline for submission extended until September 30, 2005.
First Name:
Last Name:
Date of birth:
Month
January
February
March
April
May
June
July
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September
October
November
December
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(e.g. 1978)
Sex:
Male
Female
Country:
Academic qualification:
Name of your advisor (for Ph.D. students only):
Institution:
E-mail address:
If you wish to present a talk give a title:
If you wish to present a talk provide an abstract:
Note.
Brief, plain text abstracts are preferable.
Arrival:
Day
1
2
3
4
5
6
7
8
9
10
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20
October 2005
Departure:
Day
17
18
19
20
21
22
23
24
25
26
27
28
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30
31
October 2005
Full address:
Indicate please:
a) you will participate at your own expense
b) you are requesting (partial) financial support
Note:
If you are requesting financial support under ISPM-UNESCO short term fellowship programme please read
this announcement
and submit ISPM-UNESCO (ROSTE) short-term fellowship
application form
.
Any comments:
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