Optimization Workshop Registration

Statistical and Applied Mathematical Sciences Institute
19 T. W. Alexander Drive
P.O. Box 14006
Research Triangle Park, NC 27709-4006
Tel: 919.685.9300 FAX: 919.685.9310
info@samsi.info

Large–Scale Computer Models for Environmental Systems

Simulation and Optimization Workshop
April 28-30, 2003

Registration

To apply to attend the Workshop, or for travel support, please fill out the form below, and then click the SUBMIT APPLICATION button. Items in red are required. Following submission, a confirmation of your application will be displayed. (Print a copy for your records.)

Applications will be reviewed on a rolling basis, and accepted applicants notified by E-mail. All acceptances will be sent by February 15, 2003.

Registration Fees

Students	$30
All Others	$60

Pre-payment is preferred. Please fill out the credit card form (PDF file), or send a check (payable to SAMSI) to:

SAMSI
Attn: Optimization Registration
PO Box 14006
Research Triangle Park, NC 27709-4006

Fees are also payable (by cash, check, Visa, or MasterCard) at the workshop.

Applicant Information

Name

Title

Organization

Address

City State Zip Code

Telephone (Format: xxx-yyy-zzzz)

FAX (Format: xxx-yyy-zzzz)

E-mail

URL

Interest in the Program

Please describe briefly your background and reasons for wishing to participate in the program.

Request for Financial Support

I wish to apply for financial support. Support levels will be determined by SAMSI, but will in no case exceed reimbursement for travel and local expenses supported by proper receipts. For SAMSI's records and reports, applicants for support are requested to E-mail a brief CV or resume (the 2-page format used for NSF proposals is ideal) to optimization@samsi.info. New researchers and members of under-represented groups are especially encouraged to apply.

NISS Affiliates Only

Check this box if you are from a NISS Affiliate and plan to request reimbursement from your NISS/SAMSI Affiliates Reimbursement Account. By doing so, you confirm that the request has been approved by your home institution.

Graduate Students Only

Please check the box below, and in the "special request" block, identify your advisor and dissertation topic.

I am a graduate student.

Special Requests

If you have special requests (such as dietary restrictions), please enter them below. Other questions should be sent by E-mail to optimization@samsi.info.

Submission

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