APPLICATION FORM
ICMS Instructional Conference Nonlinear PDE
Edinburgh, 8-18 January 2001


Section 1 - Personal Details

Last Name:	First Name	Title	
Status (e.g. grad student, postdoc, lecturer)	
Institution:	
Insitution's address:	
	
Postcode:	
Email:	Telephone:	
Have you any special dietary (or other) requirements?	
Age	Nationality	

Section 2 - Accommodation
Please delete inappropriate statements 

* Please reserve me a single study-bedroom and evening meals at Heriot-Watt University.  I intend to arrive on Sunday 7th January and depart on Friday 19th January. 

*I will arrange my own accommodation.  

Section 3 - Financial position
Please delete inappropriate statements
*I have sufficient funds to cover my costs: please invoice me
*I wish to apply for financial assistance and have completed an Application for Financial Support.



Signed:	



PLEASE RETURN THIS FORM TO: ICMS, 14 INDIA STREET, EDINBURGH EH3 6EZ 
BY 19 OCTOBER 2000
TEL: (0)131 220 1777; FAX: (0)131 220 1053; EMAIL: icms@maths.ed.ac.uk