Application Form for Local Support at ISSAC 2019 

Please send the filled application form to Dr. Chenqi Mou (Local Arrangements Co-chair) via chenqi.mou@gmail.com for the application. 

We will try to support as many applicants as the budget allows. The applicants will receive a notification email from Dr. Chenqi Mou after the evaluation on the application by the local organizing committee is complete. For those whose applications are approved, we will use the provided information to complete their online registration and pay the registration fees, and they will be provided a room in a selected hotel. 

1. Given name: __________
2. Surname name: _________
3. Affiliation: _________
4. Status (young researchers / PhD student / graduate student, etc): _________
5. Supervisor(s) (if you are a PhD/graduate student): _________
6. Check in date: _________
7. Check out date: _________
8. Are you willing to share a room with another supported applicant? _________
If yes, your sex: _________