IGTC Form
The fields marked with a are required.
First Name:
Last Name:
Institution:
Department:
Street address:
Country:
Canada
United States of America
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
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Angola
Anguilla
Antarctica
Antigua and Barbuda
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Austria
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Bouvet Island
Brazil
British Indian Ocean territory
Brunei Darussalam
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Burkina Faso
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Cayman Islands
Central African Republic
Chad
Chile
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Christmas Island
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Congo, Democratic Republic
Cook Islands
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Croatia (Hrvatska)
Cuba
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Dominican Republic
East Timor
Ecuador
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El Salvador
Equatorial Guinea
Eritrea
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Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
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Georgia
Germany
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Gibraltar
Greece
Greenland
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Guinea
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Indonesia
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Iraq
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Lesotho
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Libyan Arab Jamahiriya
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Macao
Macedonia, Former Yugoslav RepublicOf
Madagascar
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Maldives
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Mayotte
Mexico
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Montserrat
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Myanmar
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Netherlands
Netherlands Antilles
New Caledonia
New Zealand
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Niger
Nigeria
Niue
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Northern Mariana Islands
Norway
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Panama
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Paraguay
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Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russian Federation
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
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Samoa
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Senegal
Serbia
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Sierra Leone
Singapore
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Slovenia
Solomon Islands
Somalia
South Africa
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Spain
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Swaziland
Sweden
Switzerland
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Tanzania
Thailand
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Turkey
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Province/State:
Alberta (AB)
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Newfoundland and Labrador (NL)
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Province/State:
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Texas (TX)
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Virginia (VA)
Virgin Islands (VI)
Washington (WA)
West Virginia (WV)
Wisconsin (WI)
Wyoming (WY)
Province/State:
N/A
City:
Postal/Zip Code:
Email Address:
Students and Postdocs
Undergraduate
Graduate
I am formally registered in IGTC program
Postdoc
Letter of support
A letter of support must be provided by your advisor. Please arrange for the letter to be sent to igtc@uvic.ca. This is required for the registration to be processed.
Name of your advisor:
Course Credit
I am planning to register for the course for credit through University of Victoria.
MATH 475
MATH 575
Confirmation:
I am aware that I am responsible for course registration through University of Victoria, and that I must attend both halves of the course.
I am applying for N.B. Either course (or both ) may be selected.
first half (Infectious Disease Networks, May 10 - 20)
second half (Neuronal Networks, May 23 - June 2)
Prerequisites
I have the prerequisites in differential equations and linear algebra
I do not have the prerequisites, but I want to participate
Reason: I want to participate without prerequisite for the following reason:
Financial Support
As a student in a Canadian institute, you may be eligible for some financial support. You are eligible for the amount up to $0.00 ($350.00 per half)
I apply for financial support.
Financial Support
The financial support is only available for undergraduate or graduate students at a Canadian institute.
Additional information
.
Please write here is you have any additional information, including dietary and other special needs, that you want the organizers to know.
Registration fee
I understand that there will be a registration fee of $50 ($50 per half). This registration fee will be charged once your registration is confirmed by the organizers. For those who take the course for credit, this registration fee will be refunded.