Oporto Meeting on Geometry, Topology and Physics   Oporto Meeting on Geometry, Topology and PhysicsOporto Meeting on Geometry, Topology and PhysicsOporto Meeting on Geometry, Topology and Physics
FCUP - Isntituto Superior Técnico Faculdade de Ciências da Universidade do Porto Instituto Superior Técnico  
XXth Oporto Meeting on
Geometry, Topology and Physics
    19th to 22nd July 2012
 

Registration Form

Please complete and submit the application form below before June 30th, 2012.
The entries marked with an asterisk (*) are optional.
The fee of 150 euros must be paid by bank transfer to the following data account (A inscrição unica de 150 euros deve ser paga por transferência bancária para a conta seguinte NIB):

Client address: Rua do Campo Alegre, s/n, 4169-007 Porto
Name of Bank: Caixa Geral Depósitos
Bank address: Pç.Carlos Alberto - Porto
SWIFT/BIC Code: C G D I P T P L
IBAN: PT50 0035 0206 0000 8459 2307 5
Indication (transfer code or equivalent): OMXX, name(s) of participant(s)

Deadline: June 30th, 2012. The confirming document must be digitalized and sent to the e-mail address dflo@fc.up.pt.
Payments after the deadline suffer have a 40% increase and must be payed in the arriving day.

Students from the second and third cycle of studies (PhD programs) from Portuguese universities may have a 50% reduction in registration fee. For this, they should bring to the registration a document proving their academic status issued by the educational institution to which they are linked.. Estudantes de segundo e terceiro ciclos de estudos (PhD programs) das universidades portuguesas, podem ter uma redução de 50% na registration fee. Para isso devem trazer, no acto de inscrição, um documento comprovativo da sua situação académica passada pela instituição de ensino a que estão vinculados.

Please complete and submit the application form below before June 30th, 2012.
The entries marked with an asterisk (*) are optional.

Last name:
First name:
Affiliation:
Address:

Street:
City: Postal Code:
Country:
Email: (name@host.domain)
Male/Female: (M/F)
Date of Birth*: (Necessary only if you are applying for financial support)
month year

If you are a graduate student or recent PhD please indicate your main research interests and the name of someone willing to send a recommendation letter on your behalf if needed:

Personal Web Page*: (e.g. host.domain/~username)
Fax*:

Do you wish to give a talk (please note that it may be impossible to arrange a slot for
everyone due to the tight schedule)?

IF YES, PLEASE SEND US THE TITLE and a SHORT ABSTRACT
(preferably with a list of references):

Arrival and Departure:
The participants will be accommodated at the Hotel Tuela, which is located a few minutes' walk from the Department..

Arrival Date: day month

Departure Date: day month

Accompanying person(s):

Type of accommodation: single, double, shared double.

Note: if you chose shared double please indicate below, if you wish, the name of the participant you would like to share the room with

If you require full or partial financial support in order to attend, please explain your situation. However  we strongly encourage participants to find their own financial support.