Application Form for Financial Support

(i) Complete and return this form to the Organizing    Committee via email (meco42@sciencesconf.org). The subject of the email should read “[MECO42: Financial Support for (Applicant’s name)]”.
(ii) The deadline is 2nd of December 2016 [extended].  All documents should be received not later than this date .
(d) The MECO42 Organizing Committee will review the applications and the selection notification will be sent out via email by 10th of December 2016.

Surname / Name		
Date of birth		
Citizenship		
Affiliation / Position	

Education	

	
Academic experience 	

	
Selected publications 
(up to 10)	

	
Brief justification
for financial support