text/x-generic eustipen_application.php (PHP script, ASCII text) FRIB Theory Alliance

EUSTIPEN Request for Travel Grant

The EUSTIPEN program is intended to fund travel grants to the European Centre for Theoretical Studies in Nuclear Physics and Related Areas (ECT*) in Trento (Italy) for nuclear theorists and students whose current primary institutional affiliation is with a U.S. university, national laboratory, or other research center.

See the Eustipen page for more details about the program.

When filling out this form, please do not insert single quotes --'-- in the fields.


Please step through the entry instructions, following the stated format.

When complete, press Submit button at the bottom.

  1. First name:     Last name:
    You can put more than one name in either box as well as suffixes.
  2. Email:
    Email confirm:
    This is the email address we will use to contact you.
  3. Position title:
    E.g., faculty, laboratory staff, postdoc, graduate student
  4. Theorist? Theorist     Experimentalist
  5. Current primary institutional affiliation:
    Address 1:
    Address 2:
    Address 3:
    City:     State:     Zip code:
  6. Phone:    
    In format xxx-xxx-xxxx.
  7. Emergency contact information (required by MSU):
    Contact name:
    Contact phone:
    Contact email:
  8. Citizenship (if not U.S.):
    Visa type:
  9. Event name:
  10. Select one or more:
    Collaboration meeting
    ECT* workshop
    Training program
  11. Departure date (yyyy-mm-dd):
    Return date (yyyy-mm-dd):
  12. Purpose for travel:
    Choose from Speaker, Collaborator, Participant, Organizer, Other (specify)
  13. For ongoing collaborations, list 1-2 relevant publications, and describe the collaboration:
  14. Senior researchers only: provide justification for support (see EUSTIPEN policy ii)
  15. Upload a short CV (as text):
  16. When you have filled in all the blanks, press .