Last Name:
First Name:
Affiliation:
Postal Address:
Phone:
Fax:
E-mail:
Contact in case of emergency:
Do you wish to give a 20 minute contributed talk?
If yes, please send the title and the abstract (max 1 page) by
e-mail (preferably in LaTex form) to gpots03@math.uiuc.edu no later than May 15, 2003.
Please indicate the category that applies to you?
For graduate students or fresh Ph.D. indicate your advisor or mentor:
Do you wish to apply for financial support?
Are you eligible for other financial resources (IMA, NSF, departmental, other)? Please indicate:
Accommodation
Do you wish dormitory accommodation:
Choose the type of room (dormitory only):
If you wish to share dormitory accommodation with another person, please indicate name:
Date of arrival:
Date of departure:
We plan to have a banquet in the evening of May 30 (Friday).
More information will be posted later.
Would you be interested at this time to participate to the banquet?
