Application Form

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Application Form

School on Describing and Analyzing Solar Data for a better Prediction of Space Weather
Kigali, Rwanda: March 1st - 5th, 2021.

N.B: Deadline for Submission of Application
The completed application form are received from December 7, 2020 and should be submitted not later than December 30, 2020.

Qn 1. Demographics information/Respondent's information. 1.1 . What is your First Name? *

1.2. What is Your Last Name? *

1.3. What is your Nationality? *

1.4. What is your Country of Residence? *

1.5. My Passport number is *

1.6. Email address *

1.7. Residential address *

Qn2. Affiliation(s) 2.1. Full address of Home Institution *

2.2. What is your Position? *

2.3. Describe your Responsibilities *

Qn3. Research Interest 3.1. What is your current research interest? *

3.2. Why would you wish to participate in this school? *

3.3. Will you be presenting a paper/poster during the School? *

Yes

3.4. If your answer in 3.3 is Yes, what is the title of the your paper/poster topic? *

Qn4. Financial support. The local organizers have no funds to support all participants. This form will help the LOC to provide information for potential sponsors who may kindly accept to support the organization of the workshop and support participation of some students and Lecturers. The LOC will support by providing invitation letters for those who will need it to apply for funding or visa arrangements. 4.1. Living expenses for the duration of the workshop: a. I have my own funding and do not wish to be considered for funding support *

Yes

b. I do not have funding and do wish to be considered for funding *

Yes

4.2. Round trip travel to Kigali, Rwanda. a. I have my own funding and do not wish to be considered for funding support *

Yes

b. I do not have funding and do wish to be considered for funding support *

Yes

c. If given funding, will you be able to attend all activities of the school *

Yes

Qn5. Health Insurance Major health insurance for each of the selected participants is necessary and is the responsibility of the candidate or his/her institution and/or government. The organizing committee will not assume any responsibility for life and major health insurance, nor expenses related to medical treatment or accidental events. Do you agree to this condition on health insurance? *

Yes

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