Application for Postgraduate Students wishing to attend the
 1999 CERN School of Computing, Stare Jablonki, Poland, 
 12-25 September 1999. 

 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
    Miss Jacqueline 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 17 May 1999..
    APPLICATIONS RECEIVED AFTER THIS DATE WILL NOT BE CONSIDERED.