European Physical Society Accelerator Group EPS-AG

APPLICATION FORM
Application to be considered for the EPS-AG Prize c)

This prize will be awarded to a student registered for a PhD or diploma in accelerator physics or engineering or to a trainee accelerator physicist or engineer in the educational phase of his/her professional career, for the quality of work and promise for the future. 

The EPS-AG 2006 Prizes Selection Committee chaired by Norbert Angert, GSI, Darmstadt, will decide the winner on the basis of the work submitted to EPAC'06.

The winner will receive a framed certificate, and a cash prize of 1000 Euros and will have the opportunity to make a short oral presentation during the Accelerator Prizes Special Session during EPAC’06.

Eligible candidates must apply to be considered for the prize by the deadline for the submission of abstracts to the conference - Wednesday, 18 January 2006.  Justifications from supervisors/line managers to support applications must be received by the Secretary of the Prizes Selection Committee.

Form to be filled out by the Applicant.  The Application must be endorsed by the Head of Institute, Laboratory or University Department of the Applicant.
Family name of Applicant
First name(s) of Applicant
Position
Affiliation
Address
E-mail
Date of birth of Applicant
Please enter the Abstract ID(s) of the contribution(s) to the programme of EPAC'06  to be considered by the Selection Committee
Name, Official Title, Affiliation of the Head of Institute, Laboratory or University Department where the applicant is employed or studying and who supports the application.
Telephone no., Fax, E-mail of above person