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                              APPLICATION FORM
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                 for the School on Linear Series & Syzygies
                        Bedlewo, March 18-22, 2002


                          Please complete this form 
                               and send it to
                      bedlewo@mathematik.uni-marburg.de
    
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                    Last name: ___
                   First name: ___
      Affiliation and address: ___
               E-mail address: ___
                  Nationality: ___

          Professional status: ___
              Name of advisor: ___
                 Thesis topic: ___
      If PhD already obtained, 
                         when? ___ (year)

         Do you wish to apply 
        for financial support  
            for accommodation? ___ (yes/no)
          for travel expenses? ___ (yes/no) 
    Estimated travel expenses: ___ Euro

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