Program registration form

Systèmes Quantiques Désordonnés

For more information, send an email to : disquant@ihp.fr

IMPORTANT : all fields must be filled.

Title:

Lastname: *

Firstname: *

Birthdate: *

Nationality: *

Email address: *

Current function: *

University/Institute/Laboratory: *

Address: *

Dates of travel

Arrival: *

Departure: *

Files

Ph D students must send a CV and a recommendation letter from their thesis advisor

CV:

Only for the students. File in .pdf format.

Recommendation letter:

Only for the students. File in .pdf format.

Do you need an office ?:

yes

offices space is very limited, and will depend on availability

Do you want to be subscribed to the library for the duration of your stay ?:

yes

I wish to receive information on this trimester by e-mail.

What code is in the image?: *

Enter the characters shown in the image.

PLEASE NOTE: the application for workshops are independent.