DPG
Freiburg 2019
Freiburg 2019

WEH Communication Programme

Freiburg 2019

Please fill out the form to participate at the WEH Communication Programme for the DPG conference Freiburg 2019. The deadline to apply for a subsidy is 30 Aug 2019. Use this form for the selected DPG conference only. For EPS-, IUPAP- and large conferences a PDF form is available on the DPG webpage.

The form allows you to use the german umlauts ä, ö, ü, Ä, Ö, Ü, and ß. If you cannot type german umlauts you may use these symbols for copy and paste.

Participant information

Form of Address:

First name (25 characters at most):

Surname (40 characters at most):

Academic title:


Contact information

State a privat or institute address below; please avoid mixed information.

Institute (c/o 1; 50 characters at most):

Institute (c/o 2; 40 characters at most):

Street (40 characters at most):

ZIP code (11 characters at most):

City (40 characters at most):

Country:

University city:

Email:

Phone (20 characters at most):

Birthday (dd.mm.yyyy):

DPG membership id:

The WEH program is available for DPG members only. Grants are restriced to students and PhD students (the conference date counts). For a recent applied membership please state "000000" for the membership id.


Information on conference participation

Only one of the authors per contribution is allowed to apply for the WEH program.

Serial number of the talk/poster like "X 123" (see submission confirmation email):

Title of the submission:


Account information for travel grants

The grant can be transfered to German accounts only.

Account holder (empty for being identical to above):

IBAN:

BIC:

Reason for payment (if needed, max. 52 Zeichen):


Statement

In case a different institution grants an additional reimbursement I affirm to inform that institution about the founding by the DPG.

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