Workshop on Topics in Dehn Surgery

University of Texas at Austin
April 20-22, 2012

Workshop on Topics in Dehn Surgery
Registration Form

To register for the workshop, please complete and submit this form:

*Last Name: *First Name:
*Home Institution:
Address Line 1:
Address Line 2:
*City: *State:*Zip: 
Work Phone: Home Phone:
*E-mail Address: Fax:

The Friday evening reception is free for graduate students
and $20/person for faculty and guests.

Are you planning to attend the Friday reception? Yes No

Number of people attending the Friday reception


Do you wish to
apply for support?
(Deadline: 03/15/2012)		 No 
  Yes    If yes, continue below.

 

We can offer limited support to graduate students and postdocs for hotel accommodations and travel. Those who are offered financial support should make arrangements for hotel accommodations at either the Hilton Garden Inn or the Extended Stay America, where we have blocked off rooms. Graduate students staying at the Hilton Garden Inn will be expected to share a room.

Application for financial support

Gender:  Female Male 
Position: Permanant Faculty Postdoc  Grad Student Other: 
Arrival date: Fri Sat AM Sat PM 
Departure date: Sat AM Sat PM Sun 
Estimated expenses: Airfare: $     *Gas: $     Taxi: $
  • If you plan to drive but not to carpool, note that state law limits your reimbursement to the cost of competitive airfare.
  • For residents of Texas, Arkansas, Louisiana, New Mexico and Oklahoma, driving cost is reimbursed by mileage only, at 50.5 cents per mile, no receipts are required.
  • When carpooling, only the driver will be reimbursed.
Are you a Texas State Employee?  Yes  No
Citizen Info: US
  Permanent Resident  Alien #: 
  Non US Country:  Visa Type: 

If you have special requests, please contact us by email email. Receipts for reimbursements can be submitted at the conference or via this email address.



Email: wtds2012@math.utexas.edu
Updated: Feb 2012