IC-EATCS 1997 Advanced School

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                           GRANT APPLICATION FORM
               (to be sent together with the application form)
                             

I hereby apply for the following support for attending the 
``IC-EATCS Advanced School on Models and Paradigms for Concurrency'', 
CISM, Udine, 15-19 September 1997 :

- travel expenses: Yes  No

- living expenses: Yes  No

- participation fee:  Yes  No

When using the most economical way of 
travelling, my travel costs amount to: ________________________________

Other sources will contribute to my expenses for:

- travel expenses: Yes  No  Partially (up to _________________________)

- living expenses: Yes  No  Partially (up to _________________________)

- participation fee: Yes  No  Partially (up to _______________________)


I do not receive any further support and I hereby declare that the above
information is correct and to the best of my knowledge.

Date: _________________

Signature: ____________________________________________________________