Downloads

Application Form COMPLETE FILES WILL BE CONSIDERED If you are applying from outside Colombia and you intend to apply for financial aid, you need to send an additional form to CIMPA
Last Name:
Given Name:
Birthdate:
Citizenship:
Personal address:
Name and address of your institution:
Present position:
Latest degree:
University:
Date:
Prepared degree:
University:
Research field:
Do you belong to a research group?	Yes   No
If so, which one?
Name of person in charge:
Number of persons working in this research group:
Estimated total cost of your travel in economic class:
Details of your financial arrangements (enclose evidences):
Travel financed by:
Amount of the financing:
Stay financed by:
Amount of the financing:
Registration fees financed by:
Amount of the financing:
List of institutions (excluding CIMPA) you have applied for financial support and from which you are waiting for a reply:
Your more convenient mailing address?	Personal    Professional
Telephone :
Fax:
E-mail :
The quickest and most reliable way to contact you:
Ordinary mail
Fax
Telex
E-mail
Do you have a personal insurance covering ilness, injuries or other risks?	Yes   No
NOTE : In any case CIMPA will not cover your care, hospitalization and repatriation expenses. Health insurance is mandatory.