CIMPA course submission

I. Host institution

Country

Town

Name and address of the host institution (university ou equivalent)

first name and LAST NAME (in this order) of the director of the host department or lab:

Email of the director of the host department or lab:

Upon submission, a confirmation email will be sent to the director and the person submitting the request.

First name and LAST NAME (in this order) of the local applicant

If this person is the director named above please fill in again.

Email of the local applicant

Invitation letter

Please upload an invitation letter for the lecturer signed by the director of the host institute.
One file only.
2 MB limit.
Allowed types: pdf.

II. Course

Please have a look at this document to be sure not to forget any information at the end.

Title

Summary

Duration (in hours)

Number of expected attendees

Master students, PhD students or researchers.

Niveau du cours

Context

Explain here what is the context for this course. For example, if the course will be given as a Master course, give some details on the Master (numbers of courses, number of students).

Perspectives

Explain what are the expected outputs of the course for the attendees and the local environment.

III. Speaker

LAST NAME

First name

Situation

Affiliation

Country

Town

Speaker's CV

One file only.
2 MB limit.
Allowed types: pdf.

IV. Mission and funding

Please have a look at this document to have more information.

Duration (in days)

Starting date

Ending date

Amount requested from CIMPA for travel (visa included) €

Amount requested from CIMPA for local expenses (housing, food) €

Note that it is highly desirable that the host institution covers the local expenses. The CIMPA will cover these costs only in exceptional circumstances.

Other expected sources of funding (excluding CIMPA)

Please do not use acronyms so that the source is clearly identified.

V. Additional remarks (optional)

Additional remarks

You can add here comments or remarks to support your application.

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