INT PARTICIPANT INFORMATION Low-Energy Neutrino Physics, INT-99-2 June 28 - September 3, 1999 Name:____________________________________________________________
Title:________________________________________________________
Department:___________________________________________________
Institute:____________________________________________________
Address:______________________________________________________
______________________________________________________________
Telephone (Office):_________________(Home):___________________
Email:________________________________________________________
Fax:___________________________________________________________
Preferred length of stay:________ weeks
Mark an 'X' next to the preferred
week(s) for your visit.
Week
Week
June 28
August 2
July 5
August 9
July 12
August 16
July 19
August 23
July 26
August 30
Topics on which you may wish to give a seminar:
_____________________________________________________________________________
Please list subfields which are of interest to you:
_____________________________________________________________________________
List people with whom you would like your visit to coincide:
_____________________________________________________________________________
Please fax or mail this form to
Maria Francom at the address below as soon as possible but no later
than January 8, 1999. Or to request an email version contact
francom@phys.washington.edu
Institute for Nuclear Theory
University of Washington
Box 351550
Seattle, WA 98195-1550
Tel: 206-685-3509
Fax: 206-685-3730
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