You must have JavaScript enabled to use this form. Collected data will be only transmitted to organizers and managers of this event. They will be destroyed within 36 months after registrations will be closed. According to the Data Protection Act of January 6th, 1978, you have at any time, a right of access, rectification and opposition to all of your personal data. To exercise this right, please send us an email at <contact at lebesgue.fr>. Your identity Civility (required) Civility (required) - Select -Mr.Ms.Other… Enter other… Last Name (required) First Name (required) Position (required) Position (required) - Select -Phd studentPost-docAssistant professorResearcherProfessorOther… Enter other… University (required) Professionnal email address (required) Professionnal postal mail address Practical information Reminder: the event Name of the event will be held from <date to date>. Arrival date Departure date I need an invitation letter for a visa éléments de facturation teeshirt3 je veux le teeshirt texte description j'en veux pas Dejeuner 29/10 : 15€ je déjeune je ne déjeune pas Diner de gala 29/10: 30€ je participe au diner je ne participe pas Excursion au mont st michel : 10€ je participe à l'excursion je ne participe pas Aide financière Les aides financières seront accordées en priorité aux étudiants et aux jeunes chercheurs. Montant de l'aide financière demandée pour le voyage (en €) Type d'aide demandée pour le logement Aucun remboursement demandé Réservation d'une chambre en cité universitaire Remboursement des frais de logement (max : 40€ par jour) Comments Example: food, mobility... Survey The Center Henri Lebesgue will carry out a survey on the scientific impact of this semester within about three years. It will contact you and propose you to answer this survey.