Semaine d'Étude Maths-Entreprises (Jan 29 - Feb 2, 2018) - Funding Application

Personal Information

Thank you for your interest in the Semaine d'Étude Maths-Entreprises from Jan 29 - Feb 2, 2018 at the Université Lille 1.

Please note this funding application form contains three parts: Personal Information, Affiliation Information, and Funding Information. All three pages must be completed in order for your application to be considered.

1. Personal Information

First Name *This question is required.

Middle Name

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Sex *This question is required.

2. Contact Information

Current Mailing Address *This question is required.

Apt/Suite/Office

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Email Address *This question is required. This question requires a valid email address.