Application for the
September 18-22, 2023
MDC, Berlin
Please fill out this page and submit it by E-mail to mailto:ngs.complex.traits.course@gmail.com. Please simply paste
the form into a body of an e-mail and fill out the form.
First name: _____________________________________________________
Last name: _____________________________________________________
Title:________________________________________________________________
Highest
Degree(s)______________________________________________________
Company / University
__________________________________________________
Department:
__________________________________________________________
Address: _____________________________________________________________
____________________________________________________________________
____________________________________________________________________
City __________________________Country________________________________
Tel. number:
_________________________________________________________
E-mail:
______________________________________________________________
Male/Female__________________________________________________________
Are you a
________pre-doctoral student _________post-doctoral fellow,
______faculty or _________other (please specify _______________________)
Will you need a visa to enter Germany to
attend the course?
(___) yes (___) no
If
you will need a visa to attend the course please give the address for the
German consulate where you will be applying for a visa.
We
will provide you with a letter to aid you with your visa application
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Special Interests (e.g., Bipolar Disease, asthma, method
development, etc.)
______________________________________________________________________________
______________________________________________________________________________
Applications are accepted on a "first come, first served"
basis. Applications will be accepted after the due date; if the course is
filled, you will be placed on a waiting list.
Payments directions: Please send no money now.
Applicants accepted for the course will receive payment instructions.