Application for Postgraduate Students wishing to attend the 2001 CERN School of Computing, Santander, Spain, 16-29 September 2001.
TITLE (Mr., Mrs., Miss, ...) ________________
FAMILY NAME: ________________________________ (in capitals) FIRST NAME: ________________________________ (Underline name to be used for badge) DATE OF BIRTH:_______________________________ SEX: M______ F______ NATIONALITY: ________________________________ E-MAIL ADDRESS: _____________________________
ADDRESS OF HOME INSTITUTE OR DEPARTMENT* __________________________________________________________ __________________________________________________________ __________________________________________________________ *for participants presently working at CERN, please state whether you are a:
Fellow ___ Paid Scientific Associate___ Unpaid Scientific Associate___ Doctoral Student___ Technical Student___ Cooperant____ If so, please give the address of your institute or department in your HOME COUNTRY.
CERN STAFF MEMBERS___ should give their complete CERN address.
POSTAL ADDRESS TO BE USED FOR MAILING OF DOCUMENTS _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ Tel:___________________ Fax:____________________
FIELD OF SPECIALIZATION: - High-energy physics _____ - Computing Science _____ - Other (specify) ____________
ARE YOU INVOLVED IN HIGH-ENERGY PHYSICS? Yes____ No____
ARE YOU INVOLVED IN ANY SUPPORT ACTIVITY LINKED TO HIGH-ENERGY PHYSICS? Yes____ No____
ARE YOU INVOLVED IN A CERN EXPERIMENT? Yes____ No____
KNOWLEDGE OF ENGLISH: - Reading: VG____ Good____ Fair____ - Writing: VG____ Good____ Fair____ - Speaking: VG____ Good____ Fair____
UNIVERSITY EDUCATION: - Institute:_____________________________________________ - Locality: _____________________________________________ - Attended: From_______________ To _____________________ - Qualifications obtained:_______________________________ Present stage of studies:______________________________
FOR WHAT QUALIFICATION ARE YOU WORKING AT PRESENT?________ __________________________________________________________ WHEN DO YOU EXPECT TO OBTAIN IT?__________________________
HAVE YOU EVER WORKED AT CERN?________________ - If so, give dates:_________________________ - In which Division?_________________________
HAVE YOU APPLIED TO ATTEND ANY OF THE PREVIOUS SCHOOLS ORGANISED BY CERN? - If so, which? Computing_____ Physics_______ - Which year?____________________ - Was your application accepted ________ or rejected _______?
HOW DID YOU HEAR ABOUT THE SCHOOL? First Announcement____ Poster____ E-mail____ WWWeb____ A colleague____ Supervisor____
Date: _____________ Signature: ________________________ ----------------------------------------------------------------------- Notes: 1. Please complete this application form and prepare a 100-word descrip- tion of your current work and indicate the computer(s) and programming language(s) with which you are most familiar. Please not that we would like this description to be sent by e-mail to the following address: Computing.School@cern.ch. Your completed application form MUST be accompanied by a FORMAL LETTER OF REFERENCE from your professor or supervisor, who should return them to Mrs Jacqueline Franco-Turner, School of Computing, CERN, CH-1211 Geneva 23, Switzerland.
2. CLOSING DATE. Applications, together with a letter of reference, must reach the above address at the latest by 30 May 2001.. APPLICATIONS RECEIVED AFTER THIS DATE WILL NOT BE CONSIDERED.