Application Form

This form gets sent to the CRSC; contact Deborah Leistikow if you have any questions.

Name:

Affiliation:

Home Address:

City, State, Zip Code:

Phone #:

E-mail Address:

Adviser/Recommender:

Adviser/Recommender Affiliation:

Adviser/Recommender Phone #:

Adviser/Recommender E-mail:

Describe your research interests:

Explain why you are interested in participating in this workshop:

Please mail your transcripts and recommendation letters to:

Deborah Leistikow

Program Assistant

Center for Research in Scientific Computation

North Carolina State University

Box 8212

Cox Hall 509-F

2700 Stinson Drive

Raleigh, NC 27695-8212

Voice: 919-513-7436

Fax: 919-515-8967

Email: .