The Jefferson Laboratory Upgrade to 12 GeV INT-09-3 September 14 - October 16 & October 26 - November 20, 2009
Family name: First name: Professor Research Associate Graduate student Other Department: Institute: Address: Office Phone: Home Phone: Fax: E-mail: Preferred length of stay: Please check the box next to the preferred week(s) for your visit (Dates below are Mondays). Sept. 14 Oct. 5 Nov. 2 Sept. 21 Oct. 12 Nov. 9 Oct. 26Nov. 16 Topics on which you may wish to give a seminar: Comments:
Professor Research Associate Graduate student Other
Department:
Institute:
Address:
Office Phone: Home Phone:
Fax: E-mail:
Preferred length of stay:
Please check the box next to the preferred week(s) for your visit (Dates below are Mondays).
Topics on which you may wish to give a seminar:
Comments: