CERN School of Computing

Santander, Spain

16-29 September 2001

SCHOLARSHIP APPLICATION*

Please fill in, sign and have officially stamped and signed by your Institute.  This form must be returned to:

Mrs J. Franco-Turner, CERN School of Computing, CERN, 1211 Geneva 23, Switzerland

tel: +41 22 767 5049/fax: +41 22 767 71 55

The closing date for applications is 30 May 2001

I, the undersigned, hereby certify that I am unable to obtain funding from my Home Institute for one, or both, of the following items:

1.   Registration fee of SF. 1,750 (covering the cost of the School, board and lodging) _______

and/or

2.  The cost of travel (by second class train or equivalent value) to and from Santander ______

     (Please specify (in US dollars) the amount you will require) ________

I therefore apply for a Scholarship, via the 2001 CERN School of Computing, for the items marked above.

Name:                                                                                                                                

Nationality:                                                                                                                        

Date of birth:                                                                                                                     

Address of Home Institute                                                                                                   

Your signature:                                                                                                                   

(Your Institute's stamp and official signature):

*The scholarship covers the cost of the course fee, including board and lodging.  In exceptional cases, a contribution towards travel costs could be considered.  The scholarship is primarily intended for applicants from countries that are not members of CERN.  Between equally qualified candidates, priority will be given to applicants from developing countries and those not requiring travel assistance.  The CERN School of Computing application form and a formal letter of reference must accompany this application (see Bulletin No. 1).