Registration for
  Summer School in Conformal Geometry, Potential Theory and Applications
  National University of Ireland, Maynooth.
  Tuesday 23 June to Saturday 27 June 2009.
  http://www.maths.nuim.ie/summerschool09/

Thank you for your interest in the summer school. In order to register, please
complete the following form, save the file as yourname.ss09.txt, and send the
file to ss09@maths.nuim.ie as an attachment. There is no registration fee. 


SURNAME:

FIRST NAME:

EMAIL ADDRESS: 

AFFILIATION: 

ARE YOU A STUDENT (indicate degree being pursued and name of supervisor)?

ARE YOU A YOUNG RESEARCHER (<= 35 years of age)?

IF YOU ARE A STUDENT/YOUNG RESEARCHER, DO YOU REQUIRE FINANCIAL SUPPORT? YES/NO. 
(once we have an idea of numbers and available funds, we will contact you by email).

HAVE YOU ARRANGED ACCOMMODATION? YES/NOT YET 
We will arrange accommodation for supported individuals (speakers plus a limited
number of students and young researchers).  All others should see the
Accommodation section of the Summer School website.

PLANNED ARRIVAL DATE:

PLANNED DEPARTURE DATE: 

DO YOU PLAN TO COME ON THE BUS TOUR ON THURSDAY 25th? YES/NO. 
IF 'YES',
NUMBER COMING ON TOUR: 1/2
(there may be a small charge for the tour)

DO YOU PLAN TO COME TO THE CONFERENCE DINNER ON FRIDAY 26th? YES/NO. 
IF 'YES',
NUMBER COMING TO DINNER: 1/2
(the cost of the dinner will be at most 35 euros and is payable on the first day
of the summer school)

DO YOU WANT TO GIVE A 25-MINUTE TALK? YES/NO.
(there are a limited number of short talk slots available. We will do our best
to accommodate everyone)

IF YES, TITLE: 
SHORT ABSTRACT: