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CNG Workshop

Genomic Tools for Disease Studies and Other Applications

Maison de la Chimie, Paris, France (25 th-26 th Sept, 2006)

Contact : atelier2006@cng.fr

Application Form

PLEASE COMPLETE IN BLOCK CAPITALS (1 FORM PER APPLICANT)

APPLICANT DETAILS:

Family Name, First name: ___________________________________________________

Job Title: __________________________________________________________________

Organisation: ______________________________________________________________

Postal Address:_____________________________________________________________

____________________________________________________________________________

Country: ___________________________________________________________________

Telephone:________________________________________ Ext: ____________________

Fax: ____________________________ E-mail: ___________________________________

In addition to the above, please provide:

• Biosketch of applicant : A short statement of research interests outlining your current level of knowledge and experience in methodology/statistical methods and up to 5 publications.

Name:

Biosketch:

WE ANTICIPATE HIGH DEMAND, AND GIVEN THE LIMITED NUMBER OF PLACES, WE ADVISE YOU TO APPLY AS SOON AS POSSIBLE

APPLICATION FORM AND ACCOMPANYING DOCUMENTS SHOULD BE SUBMITTED TO:

SCIENTIFIC SECRETARIAT, CENTRE NATIONAL DE GENOTYPAGE,
2 RUE GASTON CREMIEUX - CP 5721, 91057 EVRY CEDEX, FRANCE

or by Fax : +33 (0)1 60 87 84 85

or by E-mail : atelier2006@cng.fr