Please return form with USD $30 registration fee payable to Math Dept, NCSU at the following address:
Naihuan Jing, Department of Mathematics
North Carolina State University, Raleigh, NC 27695-8205
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REGISTRATION DEADLINE: April 1, 2010
If you are applying for financial support, you should send in the form early.
Note: As of Mar. 15, we have received more applications than we can
actually support.
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Last
Name:...............................Title:...........................................
First Name:..............................
SSN:............................................
Home
Institution:..........................................................................
Mailing
Address:................................................................................................................................
...............................................................................................................................................................
Home Address:
.....................................................................................................................................
(The accounting office requires home address for reimbursement purpose)
Phone No: ........................Fax Number:
..........................
E-mail: ..............................
Reservation of Dormitory accommodation, Yes...., No.....
Arrival date: ........... Departure Date: .........
Are you applying for financial support? Yes......., No.....
Estimated travel cost: .........
(If you apply for support, please return the registration form as soon
as possible for full consideration)
Graduate student? Yes...., No .....
If yes, please give the name of your
adviser:...........................
Air-conditioned dormitory for 5 nights costs approximately 170 US
dollars
for single room
or $130 for double room from May 24 to May 29, 2010 excluding food.
Please
register
early since the number of rooms available is limited. Limited
funds
are available to support part of the local expenses and/or travel.
Preference
will be given to graduate students and underpresented researchers.
Two requirements for International Participants:
1) Non-US citizens need to have appropriate visas (B-1, F-1, J-1 etc)
or
a "WB"(Waiver of Business) stamp to get reimbursement. Participants
from
England, France, Germany etc. can get the "WB" stamp at the entry port.
2) You need to use US flagged flights if you get travel support.
If you don't want to stay in dorm, please make your own reservation
at: Brownstone Hotel 919-828-0811
or Velvet Cloak Inn 919-828-0333
Signed: .................................. Date: .......................