SUBSCRIPTION FORM for

 

SUMMER-SCHOOL (7-14 July) or CERG INTENSIVE COURSE (14-21 July)

 

Dornbirn (Austria), July 2002

 

 

Family name:                                                   First name:

Date of birth:                                                   Address:

Country:                                                           Postal code: 

Function and Title:

Tel./Fax.:                                                         E-mail:

FIELD AND LEVEL OF STUDY/EDUCATION:

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

RESEARCH AND/OR PROFESSIONAL EXPERIENCE

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

COURSE CHOICE (please, read course programme first)

 

A. Summer-school:

            One-week Course 7-14 July 2002          :                       Yes / No

            Fieldwork:                                                                   Yes / No

            When yes, indicate nr. of weeks (1-4):   ______

            Subject(s) of interest: _____________________________________________________

 

B. CERG Intensive Course:

            One-week Course 14-21 July 2002        :                       Yes / No

 

APPLICATION FOR IAG GRANTS for Summer School and CERG Intensive Course (reserved for young geomorphologists, under 35 years old, from less favoured countries of Africa, Latin America and Asia; for details see course programmes)

I wish to apply for IAG grant:                           Yes / No

If yes, I enclose a one page CV:                       Yes / No

 

APPLICATION FOR UNESCO GRANTS for Summer School (reserved for young professionals, under 35 years old, from less favoured countries of Africa, Latin America and Asia; for details see course programmes)

I wish to apply for an UNESCO  grant:             Yes / No

If yes, I enclose a one page CV:                       Yes / No

 

Please send completed form(s) to: Dr. A.C. Seijmonsbergen b/a IBED-Fysische Geografie Nieuwe Achtergracht 166 NL-1018 WV Amsterdam, The Netherlands Tel: +31 20 5257427   E-mail: A.C.Seijmonsbergen@science.uva.nl