Registration Form

Privacy Statement: The information requested on this form is collected under the British Columbia Freedom of Information and Protection of Privacy Act for the specific purpose of request for registration in the Industrial Problem Solving Workshop and Graduate Industrial Mathematics Modelling Camp 2008 conference and will not be shared with 3rd parties. For the purposes of compliance with the Act, we request that business/academic contact information, rather than personal contact information be provided wherever possible.

For information about the collection and use of this information please contact the PIMS Central Office at the University of British Columbia 604-822-3922.

For an application to be complete, we must receive a letter of recommendation from your supervisor. The recommendation letter must be emailed to gimmc@pims.math.ca by April 30.

There is no registration fee and accepted participants will be given some support towards living expenses. The support amount most likely will be $100 per week towards food. Free housing also is being provided on campus. Thus, arrival and departure dates must be provided. Applicants are strongly urged to apply for both events and preference will be given to applicants attending both the GIMMC and IPSW.

Please provide the following details.

Mandatory fields in orange.

Given Name:
Family Name:
Institution:
Department:
Address Line 1:
Address Line 2:
Address Line 3:
City:
Province/State:
Country:
Postal/Zip Code:
Email:
Phone number:
Gender (for statistical purposes only):
Registration Category:
Which conferences will you be attending:
In a short paragraph (less than 100 words) outline your motivation to participate:


© 2006 Pacific Institute for the Mathematical Sciences