École de sciences avancées de Luchon
School of advanced sciences of Luchon

Registration form for Session I
"Network analysis and applications", June 21 - July 5, 2014

Family name:                                                                     Given name:

Male: (  )             Female: (  )

Position:   faculty (  ),   permanent researcher (  ) ,   postdoc (  ),   PhD student (  ),   master student (  )

For students /postdocs:   year of PhD (                  ),   start year at University (                  )

For students (name of PhD advisor or professor at University):

Affiliation (Lab and/or Univ address, Country):
(continued)

Email:

Participant status: student (  ) fee 500 euro; observer (  ) fee 600 euro;

Request for reduced registration fee 300 euro
(only for master-PhD students, postdocs at student participant status):

Request to present poster/short oral presentation
Title:

SIGNATURE:                                                                         Date:

Participants should email signed registration form to (with "Subject: ecole de Luchon"):

Secretary Malika Bentour: Malika.bentour@irsamc.ups-tlse.fr

payments are accepted at the account given on Registration page
before May 16, 2014