DIMACS Special Focus on Computational and Mathematical Epidemiology:

Summer School Tutorials: Epidemiology for Mathematical Scientists

APPLICATION FOR FINANCIAL SUPPORT

Limited financial support is expected to be available. How much we offer will depend on the number of applications received and might have to be limited to waiver of registration fees for some of the applicants.

Your Name:

Your organization

Department:

Street Address:

City:

State:

Zip Code:

Phone:

Fax:

E-mail:

Web page URL:

I have registered for:

__ Tutorial I: Introduction to Epidemiological Studies only

__ Tutorial II: The Foundations of Molecular Genetics for Non-Biologists only

__ Both Tutorials I and II

I would like to apply for:

__ Waiver of registration fee

__ Local expenses (hotel, meals) in the amount of ____

__ Transportation costs in the amount of ____

Please explain in a few sentences why you need the support, what sources of support you might have, and how you would expect to benefit from the Summer School.

* Please email this application to the Computational and Mathematical Epidemiology Summer School Program Administrator at: workshop-coordinator@dimacs.rutgers.edu