CIMPA-UNESCO-ARGENTINA School K-theory, cyclic homology and group representations 7/29/96 - 8/9/96 Mendoza, Argentina {\bf Last date for inscription:} May 15, 1996\\ Information: cimpa96@dm.uba.ar The following form must be sent to CIMPA. ********************************************************************* CIMPA CIMI APPLICATION FORM COMPLETE FILES WILL BE CONSIDERED Title of the CIMPA School: .......................................................................... .......................................................................... Did you already participate in a CIMPA school? If you did, please list title(s) and year(s) of the School(s): .......................................................................... .......................................................................... Name: ................................................................ Given name: ........................................................ Birthdate: .........................Sex: ............................ Citizenship: ....................................................... Personal address: ................................................. .......................................................................... .......................................................................... .......................................................................... .......................................................................... Name and address of your Institution: ............................. .......................................................................... .......................................................................... .......................................................................... .......................................................................... Present position: ................................................ Latest degree (specify date and university): ............... .......................................................................... .......................................................................... Prepared degree (specify university): ........................ .......................................................................... Research field: .................................................... .......................................................................... Do you belong to a research group? Which one? ........................................................ Name of the person in charge: ............................... Number of persons working in this research group: ......................................................................... Details of your financial arrangements (enclose evidences) : Travel : ............................................................ Stay : ............................................................. Registration fees : .............................................. List excluding CIMPA institutions you have applied for financial support. .......................................................................... .......................................................................... .......................................................................... .......................................................................... Your more convenient mailing address? Personal \x( ) Professional \x( ) Tel : ............................ Fax: .............................. E-mail : .............................................................. The quickest and most reliable way to contact you (ordinary mail, fax, telex, e-mail): ........................................................................... Do you have a personal insurance covering illness, injuries or other risks? ........................................ NOTE : In any case CIMPA will not cover your care, hospitalization and repatriation expenses. Health insurance is mandatory. Date and signature To be returned to: CIMPA, 1 Avenue Edith Cavell, 06000 Nice, FRANCE Together with: - 1 letter stating your motivations - 1 curriculum vitae (indicate all your works and research groups, international collaboration) - 2 different recommendation letters - 2 passport photographs ********************************************************* Centre International de Mathematiques Pures et Appliquees 1, av. Edith Cavell - 06000 NICE - France Tel: (33) 93 53 18 43 Fax: (33) 93 81 73 48