AIMS (African Institute for Mathematical Sciences)
APPLICATION FOR ADMISSION

Africa@home School on
VOLUNTEER COMPUTING FOR AFRICA, July 16-22, 2007

Complete this application before May 15th 2007.

Fields marked with an asterisk (*) are required.

Personal Information

Surname *as in passport or South African ID card
First names *as in passport or South African ID card
Sex *	Male Female
Date of birth *
Nationality *
Country of birth *
Country of normal residence *

Contact Information

Mailing address *including street, city, postcode and country
E-mail *
Telephone *
Fax
Emergency contact *Name and telephone of nearest relative or person who should be informed in case of emergency

Company or Institution Information

Name of company or institution *
Details of current occupation or study *
Dates of employment or attendance *	to
Most relevant degrees attained and date / institution granted *

Supporting Information

Please send a CV (not more than 4 pages) listing your qualifications, work experience, computing experience, and any other relevant skills e.g. scientific applications or programming languages with which you are familiar.
Will you be sending a CV?
Yes, by e-mail Yes, by fax No
(Email: ; Fax: +41 22 800 1437)

Africa@home is interested in selecting researchers and lecturers who will propagate the skills learned at this course. If you teach regularly, please indicate the institution, the level at which you teach, and how many hours per week:

If you are a teacher, please send a supporting statement by the head of your department or an appropriate senior person acquainted with your academic work and/or teaching ability & duties.
Will you be sending a supporting statement?
Yes, by e-mail Yes, by fax No
(Email: ; Fax: +41 22 800 1437)

Miscellaneous Information

Africa@home has a few scholarships for travel and living costs. However, it is preferable if your institution subsidizes your travel. Indicate how much your institution will contribute:

How did you hear about the Africa@home / AIMS School on Volunteer Computing?

Important

Although we will do everything in our power to make you comfortable, the focus of this course is teaching and learning. We expect attendees to participate in an intensive practical and academic environment. The accommodation is similar to a university residence with single rooms and shared washing facilities. Three meals per day are provided. It is, however, not a hotel and those not happy with the facilities are expected to supplement these themselves. You must provide your own toiletries. There is a laundry facility. A certificate of completion will be given only to candidates who have put in the required effort to complete the practical components of the course.

Information given in this form will be used to form part of a computerised record and to guide admission decisions. Africa@home's admission decisions are final & non-negotiable.

Please read the following and then select the checkbox if you agree:

I confirm that the information that I have given in this application is true and correct to the best of my knowledge. I acknowledge that AIMS reserves the right to discontinue my participation in case of disruption of activities. I acknowledge that AIMS could cancel the course if there is insufficient interest to make it viable.

Africa@home is supported by a grant from the
Geneva International Academic Network (GIAN)