45th session
Département de mathématiques et de statistique
Université de Montréal

Combinatorial Optimization: Methods and Applications

June 19-30 2006

Application form

Information (total consideration if application received by February 28, 2006:
(May 2006 - financial assitance is no longer available)

Diane BÉLANGER, coordinator
Séminaire de Mathématiques Supérieures
Université de Montréal
C.P. 6128, succ. "Centre-ville"
Montréal, Qc Canada
H3C 3J7

Tel.: (514) 343-6111 ext. 2710       Fax: (514) 343-5700

belanger@dms.umontreal.ca
Name:
First name:
Sex: M  F
Date of birth:(yyyy/mm/dd)
Nationality:
Institution:
Department:
Address (institution):
City/Cedex:
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Country:
Postal code/Zip code :
Office telephone:
Address (home):
City/Cedex:
Province/State:
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Postal code/Zip code :
Home telephone:
E-mail:
Title or function:
Specialisation:

1) Accommodation

Do you need a room at the Résidences? (Single rooms only):

(SMS has a preferential rate of $ 200.00 CND per week)

 Yes  No
2) Financial Assistance
Do you need financial assistance for the accommodation? Yes No
Do you need financial assistance for your living expenses (meals)?

(Amount will be attributed according to the SMS budget)

 Yes No
Do you need financial assistance for transportation?

Yes No
If so, approximately what amount will you need for transportation?
(Amount will be attributed according to the SMS budget)

Last degree or diploma:     Year:
At which institution?
If you are a student, name of your supervisor:
Recent publications or very brief description (4-5 lines) of current research :

Additionally, please submit a copy of your C.V. (Microsoft Word or PDF format) to Mme
Diane Bélanger.