Quantum Information Theory APPLICATION FORM
1. Application form
Please complete this form if you wish to attend the workshop. The closing date for applications is 20 June 2019 for those seeking financial support, while other applications will be considered until 20 July. All applicants will be notified of decisions in due course. All successful applicants will be required to pay the workshop registration fee of 100.00 GBP.

1. Title: *


2. First name: *


3. Last name: *


4. Email address: *


5. Institution: *


6. There are limited funds available for financial support. PhD students and early career researchers will receive priority. If you wish to be considered for financial support, please indicate below the level of support you would require.


7. If you are applying for financial support (see Q6 above), please give a brief description of your background and how it relates to the theme of the workshop.


8. Do you wish to be considered for a contributed talk? If so, please provide the title and a short abstract.


9. Do you have any special dietary requirements?


10. If you have any other questions please add them in the box below. A member of the ICMS staff will reply to you.