WEH Communication Programme for young DPG members who live or work in Germany

Participant information

Salutation*:

(please select) Mr. Ms. Neutral salutation

First name (25 characters at most)*:

Last name (40 characters at most)*:

Academic title*:

(please select) [no title] A.d.L. apl. Prof. Dr. B.A. B.Ed. B.Eng. B.Sc. Dipl-Phys.Ing. Dipl. Dipl.-Bio. Dipl.-Biochem. Dipl.-Biophys. Dipl.-Chem. Dipl.-Geophys. Dipl.-Inf. Dipl.-Ing. Dipl.-Ing. (BA) Dipl.-Ing. (FH) Dipl.-Kfm. Dipl.-Math. Dipl.-Met. Dipl.-Min. Dipl.-NanoSc. Dipl.-Nat. Dipl.-Ök. Dipl.-Päd. Dipl.-Phys. Dipl.-Phys.Ing. Dipl.-Phys.Oec. Dipl.-Soz.Päd. Dipl.-Volksw. Dipl.-Wi.-Ing. Dipl.Wirt.-Ing. Dott. Doz. Dr. Doz.Dr.rer.nat. Dr. Dr. Dr. Dr. Dr. habil. Dr. Dr.-Ing. Dr. h. c. Dr. Ing. Dr. med. Dr. phil.nat. Dr. rer. nat. Dr. Sc. Dr. Techn. Dr.-Ing. Ing.-Mag. J.Prof. J.Prof. Dr. LAss M.A. M.Ed. M.Eng. M.Ing. M.Phys. M.Sc. M.Tech. Mag. Mag. Dr. MBA Min.-Dir. OStD OStD Dr. OStD i. R. OStR OStR Dr. OStR i. R. PD Dr. PhD Priv.-Doz. Dr. Prof. Prof. Dr. Prof. Dr. Dr. Prof. Dr. habil Prof. Dr. Sc. Prof. Dr.-Ing. Prof. em. Dr. StD StD a.D. StD Dr. StD i.R. StR StR Dipl.-Phys. StR Dr. Wiss.-Ing.

Contact information

Please state your personal details below. You can provide your private or institutional address, but please avoid mixed information. Please also use an e-mail address at which you can be contacted.

University/research institution/employer or similar (c/o 1; 50 characters at most):

University/research institution/employer or similar (c/o 2; 40 characters at most):

Street and house number (40 characters at most):

Post code (11 characters at most):

City (40 characters at most)*:

Country*:

Germany (DE)

University city*:

(please select) Aachen Augsburg Bayreuth Berlin Bielefeld Bochum Bonn Braunschweig Bremen Bremerhaven Chemnitz Clausthal-Zellerfeld Coburg Cottbus Darmstadt Dortmund Dresden Duisburg Düsseldorf Erlangen Essen Flensburg Frankfurt Freiberg Freiburg Garching Geesthacht Gießen Göttingen Greifswald Halle Hamburg Hannover Heidelberg Hildesheim Ilmenau Jena Jülich Kaiserslautern Karlsruhe Kassel Katlenburg-Lindau Kiel Koblenz Köln Konstanz Landau Leipzig Lübeck Magdeburg Mainz Mannheim Marburg Mittweida München Münster Nürnberg Oldenburg Osnabrück Paderborn Potsdam Regensburg Remagen Rostock Saarbrücken Sankt Augustin Siegen Soest Stuttgart Tübingen Ulm Wolfsburg Wuppertal Würzburg Zeuthen

E-mail*:

Phone (20 characters at most):

Birthday (dd.mm.yyyy)*:

DPG membership number*:

Have you recently applied for membership of the DPG and have not yet received your membership number? Then please enter the membership number "000000".

Information on conference participation

Only one of the authors can submit a WEH application per submitted contribution.

Serial number of the talk/poster like "X 123" (see submission confirmation e-mail)*:

Title of the submission*:

Account information for reimbursement of the grant

The travel allowance can only be paid to SEPA-enabled accounts within the Single Euro Payments Area (EU states as well as Iceland, Liechtenstein, Norway, Switzerland, Monaco, San Marino, Andorra, Vatican City State and the United Kingdom). If you do not have a SEPA-enabled account, please contact us by e-mail (weh@dpg-physik.de).

Account holder (only necessary if different from the applicant):

IBAN*:

BIC*:

Reason for payment (if necessary, e.g. for university or business bank accounts etc, 52 characters at most):

Statement

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

Privacy policy

I agree that my data may be stored and used by the DPG for the above mentioned purposes. I have read the DPG's data protection declaration and agree to it.