Financial Support Form

XXXVIIth RENCONTRES DE MORIOND
The Cosmological Model
March 16-23, 2002 , Les Arcs, Savoie, France

Partial support may be available for a limited number of young scientists (up to 35 years) who are nationals of a European Union Member State(*) or an Associated State and active inside a Member State or an Associated State at the time of the event.
(*) On 28/09/01, Member States are :
Austria, Belgium , Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, The Netherlands, Portugal, Spain, Sweden, United Kingdom,
and Associated States are :
Bulgaria, Cyprus, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia, Slovenia, Iceland, Liechtenstein, Norway, Israel.

Please return this form before December 30th 2001. to:
J. Trân Thanh Vân - Rencontres de Moriond
Université de Paris-Sud
LPTHE - Batiment 210
91405 Orsay Cédex - France. Fax : 33 (0)1 69 15 82 87


DEADLINE FOR APPLICATION : December 30th 2001.


XXXVIIth RENCONTRES DE MORIOND
The Cosmological Model
Place : Les Arcs, Savoie, France      Date : March 16-23, 2002

Name : ...............................................................  
First name : .........................................................
Date of birth : ............      
Citizenship : ................................
Professionnal status : ...............................................
University/Company : .................................................
Zip : ........... City : ............. Country : .....................
Tel : ..........................  Fax : ..............................
E-mail : .............................................................

First University (or equivalent) graduation date : ...................
Discipline : .........................................................
Institution of graduation : ..........................................
Brief curriculum vitae since graduation : ............................
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Current or projected research activities and motives for wishing to 
attend the Euroconference :
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Do you or your research group hold a grant from which Euroconference 
participation could be funded?
Yes / No
Have you applied for a grant for this purpose from any other body?    
Yes / No
If yes, what result : ..................................................
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Scientific publications of applicant (not more than 5, your best or most 
recent) Give title of paper, journal, volume and page numbers, authors.

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I declare the above truthful and sincere. I do not expect to be funded for 
Euroconference participation from other sources except as above, and if 
awarded a grant by the Euroconference organisers, I will not cover any 
expenses from more than one funding source.

Date : ........................ Signed : 

N.B. Travel funds are not  available

Comments on benefit of participation from senior scientist (Supervisor, Department Head, etc.) 

Name : ....................................................................             
Institution : .............................................................
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Position : ................................................................
Relation with applicant : .................................................
Comments : ................................................................
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Date : ......................        Signed :