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Application Form: SMR Summer School
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* Indicates required question
Email
*
Your email
2. PERSONAL DATA
Family name:
*
Your answer
First name:
*
Your answer
Date of birth:
*
MM
/
DD
/
YYYY
Academic degree:
*
Your answer
Citizenship or place of permanent residence :
*
Your answer
Organization membership/affiliation (optional):
Your answer
3. PROFESSIONAL/ACADEMIC DATA
University/Institution:
*
Your answer
Faculty:
*
Your answer
Department:
*
Your answer
Areas of Specialization:
*
Your answer
Status (Faculty/Student) :
*
Your answer
Independent Scholar
*
Your answer
Please indicate what is your interest in the summer school program
*
Your answer
5. Please write a short academic bio (Approximately 200 words):
*
Your answer
6. Contact Information:
E-mail:
*
Your answer
Address: (optional):
Your answer
Phone (optional):
Your answer
Do you wish to pay on installment plan
Yes
No
Clear selection
Opting out from
Sustenance package for the week provided by the Organizer/ I will arrange my accommodation, meals etc., and pay the participation fee only (See the Call for details)
Onsite participation/I will attend online only, according to the terms stated in the call.
Clear selection
A copy of your responses will be emailed to the address you provided.
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