Application Form
 

The application should include the following items and provide information in as much detail as possible.
 
1. Name of visitor
  - Last name - (Maiden name)
  - First name - Middle name
2. Gender : Male ( ) , Female ( )
3. Nationality:

4. Current Position:

5. Home Institute:

  - Institute - Homepage
  - Mail Address - Email
  - Tel - Fax
  - Mobile    
6. Passport Number (or Korean Registration)
7. Duration of stay at APCTP
  - Arrival
  - Departure
8. Accommodation : Do you require that the center arrange your accommodation?
  - Yes No
  - Share Faculty Apt. for 3 people (1person/room) Sangnamkwan (1person/room)
  Special Request about room
9. If you accompany family, please fill out the followings.
  - Name of accompanying person(s)
  - Male Female  
 

- Relationship

10. Medical Insurance: Do you require that the Center arrange your Medical Insurance?
-   (We will deduct your Medical Insurance Premiums from your financial support.)
 

- Yes ( )   No ( )

11. Brief curriculum vitae
   
12. Brief description of current research
   
13. List your five major scientific publications
   
14. Name of person who recommends th above scientist (if any)
  - Name
  - Address
  - Email
  - Tel - Fax
15. Scientific Activities
  1) Brief description of your scientific plans at APCTP
 
 

2) Titles of the talk (if you want to give a seminar)

 
  3) Related APCTP programs(if any)
 

16. Financial Support from APCTP If you need financial support from APCTP, please specify the reason.
   
17. Other special requests(if any):