Application form

Application

General information

• Title
  choose titleDr.Mr.Ms.Mrs.
• First name
• Second name (surname)
• Date of birth
  
• Gender
  male

  female
• Country of citizenship
  choose countryUkraineArmeniaAzerbaijanBelarusEstoniaGeorgiaKazakhstanKyrgyzstanLatviaLithuaniaMoldovaRussiaTajikistanTurkmenistanUzbekistanPolandAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaAustraliaAustriaBahamasBahrainBangladeshBarbadosBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurmaBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEthiopiaFijiFinlandFranceGabonThe GambiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKenyaKiribatiKorea, NorthKorea, SouthKuwaitLaosLebanonLesothoLiberiaLibyaLiechtensteinLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMonacoMongoliaMontenegroMoroccoMozambiqueNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPortugalQatarRomaniaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTuvaluUgandaUnited Arab EmiratesUnited KingdomUnited StatesUruguayVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe
• Please, attach your photo
  Allowed filetypes: jp(e)g, png, gif. Maximum filesize is 8 Mb
• Your address (address you want your invitation or Summer school certificate to be sent to)
• Country
  choose countryUkraineArmeniaAzerbaijanBelarusEstoniaGeorgiaKazakhstanKyrgyzstanLatviaLithuaniaMoldovaRussiaTajikistanTurkmenistanUzbekistanPolandAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaAustraliaAustriaBahamasBahrainBangladeshBarbadosBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurmaBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEthiopiaFijiFinlandFranceGabonThe GambiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKenyaKiribatiKorea, NorthKorea, SouthKuwaitLaosLebanonLesothoLiberiaLibyaLiechtensteinLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMonacoMongoliaMontenegroMoroccoMozambiqueNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPortugalQatarRomaniaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTuvaluUgandaUnited Arab EmiratesUnited KingdomUnited StatesUruguayVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe
• City
• Zip code
• Street, building, apartment
• Phone
  E.g.: + 380 (44) 111 11 11
• E-mail

Current education/profession

• Current status
  choose statusapplicantbachelor studiesmaster studiesPhD studiespostdoctoral studiesnon-academic
• University/organization
• Subject
• Position
• Knowledge of English language
  choose levelexcellentgoodfair
• Knowledge of Russian language
  choose levelexcellentgoodfairdon’t understand

Achieved education

• University
• Department
• Major subject

Course selection

• Please, read the information about AACIMP courses previously
• Course, which you would like to attend (first priority)
  choose courseApplied MathematicsSustainable DevelopmentPhysics, Сhemistry and Living SystemsInformation Technologies
• Alternative course, which you would like to attend (second priority)
  You will attend this course, in case if group of course, you prefer as first priority, would be already formed, when your application form would be considered
  choose coursenoneApplied MathematicsSustainable DevelopmentPhysics, Сhemistry and Living SystemsInformation Technologies

Accommodation

• Date of arrival
  
• Date of departure
  
• Type of accommodation
  choose typeKPI dormitory room (5 Euro per day)KPI dormitory on terms for KPI students (only for KPI students)I shall obtain accommodation privately
• Meals
  choose type3 time a dayonly dinnerI shall obtain meals privately

Fee

• Please select the type of the tuition fee you will pay
  Early fee (for 'Sustainable Development' and 'Physics, Сhemistry and Living Systems' streams participants only; registration before 20.06.2010): pay before 30.06.2010; 50 EURO - participants from Ukraine, 100 EURO - participants form other countries
  Late fee (for all streams participants; registration before 01.08.2010): pay before 3.08.2010; 70 EURO - participants from Ukraine, 120 EURO - participants from other countries
  Early fee

  Late fee

Motivation, recommendation and achievements

• Letter of motivation
  Please describe your academic/working goals and reason why you would like to attend AACIMP and the course you have applied for. Why is this course important to your studies or to your future career?
• Letter of reference
  Please attach the letter of reference from your academic advisor/teacher/manager (maximun filesize is 8 Mb; allowed filetypes: pdf, jp(e)g, png, gif, zip, rar)
• Achievements
• Please describe your involvement in students' organizations and/or projects
• Please describe your academic activities: main research achievements, participation in conferences, workshops, summerschools

Additional information

• How did you hear about the AACIMP-2010?
  choose itembeen beforefrom a friendfrom my teacherposter/flyere-mail announcementAACIMP web sitesocial networkother
• Is there any medical/health condition of yours that organizers or your tutor shold be forewarned adout?
• If there is any other information that you think is important for us to know in order to provide the best comfort for you please specify it here (food restrictions, taboos etc)
• If you have any questions about your Summer School application or comments that you would like to make about your application please add them here
• Person to be contacted in case of emergency
• First name
• Second name (surname)
• Phone
  E.g.: + 380 (44) 111 11 11
• E-mail

Terms acceptance

• Please, state your agreement to AACIMP-2010 rules
  I accept rules of participation, registration and payment