Current Trends in Mathematics: Algebra, Geometry, Differential Equations, Numerical Analysis, Applications to Biology Series of Conferences – summer 2006, Anogia - Crete Application Form Conference: ____________________________________________________________________________ Name: ____________________________________ Gender: ______ Nationality: ___________________ Date and place of birth: ______________________________ e-mail address: _____________________ Current position: ________________________________________________________________________ Postal address: __________________________________________________________________________ Research field: __________________________________________________________________________ If you wish to give a talk, please give a tentative title: _______________________________________ ________________________________________________________________________________________ Do you wish to apply for financial support? For living expenses: For travel expenses: YES / NO YES / NO If yes, please give estimated cost of tickets in euros: _____ For refund of the registration fee: YES / NO Please give the following information: 1. List which of the following degrees you hold, the University and the date awarded. University Degree: _____________________________________________________________ Master’s Degree or equivalent: __________________________________________________ Ph.D. Degree: _________________________________________________________________ 2. If you are a graduate student or hold a Ph.D. degree, please state when you were admitted in a Ph. D. program: _________________________________________________________________________ Give a short CV including information not stated above: __________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________