Summer School on
"Computational Number Theory and Applications to Cryptography"
June 19-July 7, 2006
Laramie, Wyoming

Instructions:
Please answer all questions.  The deadline for applications is April 1, 2006.  persons requesting financial aid should apply as soon as possible.  After this date, scholarships will be awarded as long as space and funs are available.

Faculty seeking support should submit a short vita and a letter describing his or her professional aspirations and what he or she hopes to accomplish by participation in this conference, and arrange to have a letter of recommendations from his/her department head sent by email to Dr. Andreas Stein (astein@uwyo.edu).

Students seeking funding should submit a supporting letter from their advisor or department head to Dr. Andreas Stein (astein@uwyo.edu).

Participants not seeking funding should fill out the housing application and indicate that no funds are requested.

Registration Form

Contact Information
                     (First)                                           (Last)                                                                                     (M.I.)
Name
University  
 
Mailing Address Address Line 1
  Address Line 2
  City, State,  
  Country, ZIP (#####-####)
Email Address  

Room and Board Information

Accommodation, Registration, Funding:
A limited number of stipends will be issued on a competitive basis and will be divided among participants.
NOTE: (For those paying for their own room and board, the rates are $700 per person for a double occupancy room and $800 per person for single occupancy room)
     

 
Faculty Male Requesting room & board stipend? (for double occupancy only) Room Type Desired
Student Female Double Occupancy
    YesNo Single Occupancy
         

Please assign as my roommate.
         
***Dormitory prices include room and weekday meals. The university provides bedding and linen, but does not provide towels and toiletries.  These rooms have a sink, but the shower and lavatory facilities are separate.***
         
 

Additional Information for Students Only

  
Are you currently working toward a Ph.D? YesNo
If so, in what area?
Who is your major professor?
Do you need to receive class credit for attending this course? YesNo
If YES, do you plan to accomplish this by Registering for an independent study course at your own university with a grade to be assigned by your major professor. Registering for the course at the University of Wyoming and then transferring credit to your own university.