Lorentz Center - Life Sciences with Industry 2019 from 11 Nov 2019 through 15 Nov 2019
  Current Workshop  |   Overview   Back  |   Home   |   Search   |     

    Life Sciences with Industry 2019
    from 11 Nov 2019 through 15 Nov 2019

 
The registration procedure is closed. All new applications will be put on a waiting list.
Family Name (Last Name): 
First Name:
Gender: 
Date of Birth:  Type yyyy-mm-dd or Press-> (required for internet access)
Institute (affiliation): 
Address: 
Zip Code: 
City: 
Country: 
Telephone:
Email: 
Personal Homepage:  (to be linked to your name in the participants list)

Almost all Lorentz Center workshops welcome participation of not-invited researchers with an interest in the theme of the workshop, space permitting, while members from the Dutch scientific community are in principle always welcome at the workshops. Please provide below any information concerning your research or background that may be helpful to the organizers in deciding concerning your admission (research field, papers on the subject, collaborations, etc.)

Please state your reasons for wanting to attend the workshop and give a list of recent publications in related areas.
Reasons for attending:  
Publications:  
Current Professional Status:  
Participants are expected to stay for the entire workshop week and will stay in the nearby hotel Van der Valk. Your accommodation will be covered. Participants will share a room with another person. Single rooms are available, upon payment of extra cost and will be charged on own account.
Arrival date: Type yyyy-mm-dd or Press->
Departure date: Type yyyy-mm-dd or Press->
Hotel needed
My special requirements regarding hotel accommodation,
meat/food are (eg wheel chair access, presence of elevator)
Please indicate which business challenge you would like to sign up for in order of preference:
First Choice
Second Choice
Third Choice
Why is this your first choice and what expertise do you have that can help complete the case successfully.  
Please state your reasons for wanting to attend the workshop
Motivation (max 100 words) 
Please state educational background (max 100 words)  
Description of current research (max 100 words) 
Recent (relevant) publications (max 100 words) 
CAPTCHA refresh captcha Insert th e captcha code into this box
I do not want my name and email address to be kept and used by the Lorentz Center for future mailings for and/or by the Lorentz Center.
I do not want my name to appear on the list of participants on the workshop website.

The organization strives to compose teams with a balanced number of participants from different backgrounds and interests. Please note that the organization aims to connect the participants to their problem of choice, however this may not be possible for everyone.

You can now  this form or  it.

   [Back]