------------------------------------------------------------------------------ I wish to apply for a Training and Mobility of Researchers grant to attend the event. Title of event:............................................................... Taking place in .....................................Date: ................... Name:................................First name:.............................. Age:.................................Nationality.............................. Professional status: ......................................................... University/Company:........................................................... Postcode:...........City:...........................Country:.................. Tel: ..................................Fax: .................................. First University (or equivalent) graduation date: .................... Discipline:........................ Institution of graduation: ................................................... Brief curriculum vitae since graduation ............................................................................... ............................................................................... ............................................................................... ............................................................................... ............................................................................... ............................................................................... ............................................................................... ............................................................................... ............................................................................... ............................................................................... ............................................................................... ............................................................................... ............................................................................... ............................................................................... ............................................................................... ............................................................................... ............................................................................... Current or projected research activities and motives for wishing to attend the Summer Schools: ............................................................................... ............................................................................... ............................................................................... ............................................................................... ............................................................................... ............................................................................... Do you or your research group hold a grant from which participation in the event could be funded? Yes/no Have you applied for a grant for this purpose from any other body? Yes/no If yes, what result? .......................................................... Scientific publications of applicant (no more than 5, your best or most recent) (Give title of paper, journal, volume and page numbers, authors) 1. 2. 3. 4. 5. Estimated costs of travel to the event (using most economical air or second class train fare) .................. FROM ........................ TO ................ Means of transport ....................... Return/single COST ..................................................... I declare the above truthful and sincere. I do not expect to be funded for participation in the event from other sources except as above, and that if awarded a grant by the organisers of the event, I will not cover any expenses from more than one funding source. Signed......................... Date.................... _____________________________________________________________________________ (Optional) Comments on benefit of participation from Supervisor, Department Head, etc. Name:.....................................Institution:......................... Position:.................................Relation with applicant:............. Comments: ............................................................................... ............................................................................... ............................................................................... ............................................................................... Date Signature -------------------------------------------------------------------------------