UNITED NATIONS EDUCATIONAL, SCIENTIFIC AND CULTURAL ORGANIZATION
and
INTERNATIONAL ATOMIC ENERGY AGENCY

the ABDUS SALAM INTERNATIONAL CENTRE FOR THEORETICAL PHYSICS

Strada Costiera 11  						Telephone: +39-040-2240226
I-34014 Trieste							Telefax:   +39-040-224163
Italy								E-mail: smr1640@ictp.trieste.it

REQUEST FOR PARTICIPATION

African Regional School in High Performance Computing on LINUX Clusters
To be held in Kumasi, Ghana, 17 - 28 January 2005
Co-organized with KNUST, Kumasi, Ghana

Please return this form before September 15, 2004 
by e-mail (above), fax (+39-040-224163), or mail to:

the Abdus Salam International Centre for Theoretical Physics
African Regional School in High Performance Computing
on LINUX Clusters (smr1640 - c/o Suzie Radosic),
Strada Costiera 11, I-34014, Trieste, Italy
_____________________________________________________________________
Each question must be answered clearly and completely.  Type or print in ink.  If more space is required, attach additional pages.	 

										A recent photograph of
										the candidate should be 
				 						attached here, signed
    									legibly on the reverse

This request will be processed only if the permanent and/or present address is clearly indicated.  The ICTP cannot process any visa request, unless all personal data is provided.
_________________________________________________________________________________

P E R S O N A L   D A T A
_________________________________________________________________________________
SURNAME/FAMILY NAME: 	First name: 		Middle name(s):



Sex:                                           MAIDEN Name (women only, if applicable):
_________________________________________________________________________________
IMPORTANT: PLEASE ALSO COMPLETE THIS SECTION, IF YOUR NAME(S) IN YOUR PASSPORT ARE SPELT DIFFERENTLY FROM THE ABOVE.
SURNAME/FAMILY Name: 	First name: 		Middle name(s):	


MAIDEN Name  For women only (if applicable):
Place of birth  (City and Country): 				Present nationality:   


Date of birth: (Year - Month - Day)
Full address of Permanent Institute: 
										Tel. No.
										Telex/Cable
										Telefax 

							Your Office: 	
										Tel. No.
										Telefax
E-mail Address: 
 
(My e-mail address may be made public on the ICTP WWW page:  YES NO )
_________________________________________________________________________________
Full address of Present Institute (if different from permanent):

until:  Date ............................................  
Institute: 								Tel. No.
										Telex/Cable
										Telefax 

							Your Office: 	
										Tel. No.
										Telefax
E-mail Address:  

_________________________________________________________________________________
Home address: 						Tel. No.



_________________________________________________________________________________
Please indicate whether mailing address should be:      Permanent __ Present __ Home __
_________________________________________________________________________________
Name and address of person to notify in case of emergency:




Relationship:     					Tel. No.:
_________________________________________________________________________________
EDUCATION (higher degrees)
University or equivalent		Years attended 				Degrees obtained
Name and place 			From          to





Seminars, summer schools, conferences or research 
Name and place 							Year






SCIENTIFIC EMPLOYMENT AND ACADEMIC RESPONSIBILITY 
Research Institution 
or University 				Period of duty 			Academic
Name and place 			From          to	 		responsibilities









Present employment and duties, and foreseen employment upon return 
to home country after the activity:



_________________________________________________________________________________
Have you participated in past ICTP activities?  Yes   __  No     __
If yes, which? 








Are you applying to any other 2005 ICTP activities? Yes __  No  __
If yes, which? 







Mention briefly your previous research experience, and explain your reasons for wishing to participate in this activity:






NB:  Our Scientific Information System keeps track of all applications made by the candidate to earlier ICTP activities.  As a consequence, when the subject of the present activity is far from your previous applications, an explanation (not more than 200 words) of your change of interest should be included.



PRESENT FIELD OF INTEREST (please indicate on the list below your TWO primary  fields of interest,in order of priority). 

10. PHYSICS OF CONDENSED MATTER 	50. PHYSICS AND ENVIRONMENT
11. Solid State Physics 				51. Solid Earth Geophysics
12. Atomic and Molecular Physics 			52. Soil Physics 
13. Materials Science 					53. Climatology and
									Meteorology
14. Surfaces and Interfaces 				54. Physics of the Oceans
15. Statistical Physics 					55. Physics of
									Desertification
16. Computational Physics in				56. Physics of the Atmosphere,
			Condensed Matter					Troposphere, Magnetosphere,
										Aeronomy
								57. Environmental Monitoring
									and Remote Sensing
20. PHYSICS OF HIGH AND			60. PHYSICS TEACHING 
		INTERMEDIATE ENERGIES 
21. High Energy & Particle Physics			61. English
22. Relativity, Cosmology and 			62. French
		Astrophysics					63. Spanish
23. Plasma Physics 					64. Arabic 
24. Nuclear Physics 				
30. MATHEMATICS 				80. MISCELLANEOUS
31. Applicable Mathematics, 				81. Others
		including:					82. Digital Computer
		Mathematical Ecology, 				Communications and 
		Systems Analysis 					Computer Networking
		Mathematical Economy 		
		Mathematics in Industry
33. Algebra						90. PHYSICS OF THE
34. Geometry 							LIVING STATE
35. Topology 						91. Neurophysics
36. Differential Equations 				92. Biophysics
37. Analysis 						93. Medical Physics	
38. Mathematical Physics 				AO. APPLIED PHYSICS
40. PHYSICS AND ENERGY 			A1. Physics in Industry
41. Physics of Nuclear Reactors 			A2. Microelectronics 
42. Physics of Controlled Fusion 			A3. Fibre Optics for 
43. Non-Conventional Energy 				Communications	
		(Solar, Wind & others) 			A4. Instrumentation
44. Nuclear Energy related				A5. Synchrotron Radiation
		technologies					A6. Non-destructive
									Evaluation
								A7. Lasers
								AA. Applied Superconductivity 
								B1. SPACE PHYSICS
								
Kindly supply a short keyword description of your current scientific activities, as follows
1) Area of research: (e.g. COMPUTATIONAL PHYSICS, COMPUTER SCIENCE)


2) Specific topic of interest:  (e.g. LINUX CLUSTERS, BEOWULF)


T E C H N I C A L   S K I L L S 


1 .  Which  programming  language  do  you  use ? 
A. fortran77 __
B. fortran90 __
C. C __
D. C++ __
E. Other (please specify)  __

2 .  What  is  your  knowledge  of  L i n u x   O . S . ? 
A. No knowledge __
B. Poor __ 
C. As experienced user __ 
D. As system administrator __

3 .   P a r a l l e l   p r o g r a m m i n g : 
A. Excellent __
B. Good __
C. Poor __
D. No experience __

4 .   Which  techniques  do  you  use  for  parallel  programming ? 
A. MPI __ 
B. OpenMP __ 
C. PVM __ 
D. Shared Memory __ 
E. Other (please specify)  __

5 .  W h i c h   k i n d   o f   h a r d w a r e   d o   y o u   u s e ? 
A. Beowulf cluster __
B. Proprietary solution     (please specify) __

6 . Which kind of free libraries do you use in your applications ? 
A. Lapack __ 
B. Blas __ 
C. FFTW __ 
D. Scalapack __ 
E. Other (please specify)  __


List your scientific publications including books and articles (authors, title, Journal) in the period 1999-2004:











Kindly state any positions you hold in the scientific administration of your Institution or any of the national scientific Institutions.



It would be of assistance to the Selection Committee if this request for participation were accompanied by a letter of recommendation, especially for junior physicists 
_________________________________________________________________________________
Indicate below your proficiency in the English language

Reading:   			    Writing:			         Speaking
Good  _   Average  _   Poor  _     Good _   Average  _   Poor  _       Good  _   Average  _  Poor  _
_________________________________________________________________________________

APPLICABLE ONLY FOR CANDIDATES FROM DEVELOPING COUNTRIES   (Important:  Owing to limited funds, support for travel will be granted only in exceptional cases.  Therefore, every effort should be made by applicants to secure support for their fare (or at least a partial contribution) from their home country). 

Request for Financial Assistance:   (Please tick ONE box only)

___  Full Travel + Subsistence
 
___  Subsistence only

___  Half Travel + Subsistence 

___  No financial support requested


I certify that if granted funds for my travel, I shall attend the whole activity

.......................................... 
Signature 
_________________________________________________________________________________
I certify that the statements made by me above are true and complete.  
If accepted, I undertake to refrain from engaging in any political or other activities which would reflect unfavourably on the international status of the ICTP.  I understand that any breach of this undertaking may result in the termination of the arrangements relating to my visit.
_________________________________________________________________________________ 

Signature of applicant 			       Date


______________________________      _________________________