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             25th Course of the International School of Geophysics
               9TH INTERNATIONAL WORKSHOP ON NUMERICAL MODELING
                OF MANTLE CONVECTION AND LITHOSPHERIC DYNAMICS
              (EMFCSC, Erice, Sicily, Italy 8-14 September, 2005)
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                                Application form
                          (* indicates required fields)

  First Name*:    
  Mid:       
  Last Name*:     
  Position:                    
  Institution*:                   
  Address 1*:                   
  Address 2:                   
  City*:       
  State/Prov.:     
  ZIP*:       
  Country*:     
  Phone*:       
  Fax*:     
  e-mail*:                   
  I plan to attend the school
  ( ) for the whole period
  ( ) from ______  to ______                
  I wish to present a poster:
  Preliminary poster title:     
  Fields and subjects on which the applicant is presently working:    
  Three publications relevant to the meeting:     
 
  I wish to apply for a grant for living expenses (No/Yes/Partial):                                
   
For graduate students: 
  Motivation to participate in the meeting:    
  Name/Institution of the advisor(s):      

After submission of this form, graduate students should have their
academic advisor send an e-mail to erice2005@ingv.it in support of their
application.