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

FRIB-TA%20support%20%3E%20EUSTIPEN%20program

EUSTIPEN Request for a 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 .