HPSS 2018 Registration Form

Dear applicant,

thank you very much for your application to HPSS2018. We would like to ask you to fill the questionnaire below and send it back to

hpss_contact@fz-juelich.de

as soon as possible. The application deadline is May 15th, 2018. We will inform you on our decision shortly thereafter.

With best regards,
The organizing committee

	Questionnaire for HPSS 2018

Last name:		                                                                                                                 
First name(s):		                                                                                                                
Institution:		                                                                                                                
Full street address:	                                                                                                                

			                                                                                                                

Gender:              	male / female (for room reservations)

Degrees obtained (master/bachelor/...), thesis titles and year:

			                                                                                                                

			                                                                                                                

Year of study:		                                                                                                                

List of physics courses attended in the last year:

			                                                                                                                

			                                                                                                                

Main physics interest (topic + experimental/theoretical):

			                                                                                                                

Name, affiliation and email-address of one reference, whom we can contact for a letter of 
recommendation:

			                                                                                                                

			                                                                                                                

Please note here, if you have special needs (accommodation, food, etc.)

			                                                                                                                

In case you also need to apply for a visa in case of acceptance, we would like to have the following additional information:

Date of birth:		                                                                                                                
Place of birth:		                                                                                                                
Passport no.:		                                                                                                                
Place issued:		                                                                                                                
Nationality:		                                                                                                                
Place of the German consulate closest to you:

How did you hear about the school?