Application Form : Geo.X

(1) Personal Details

Personal Details

Family name / surname

Given name(s) / first name

Contact Details

Phone

E-mail address

I am a scientist at...

Geo.X partner institution

(2) Scientific Topic

Scientific topic or research idea

Short summary

Planned event format

Round table discussion

Workshop

Scientific retreat

Others

If others

Envisaged time window

Justification for requested funds

Requested funds (total)

Do you need organizational support from the Geo.X coordination team?

Yes

(3) Current Stage, Partners and Further Information

What is the current status of your group?

New group

Existing group

If the group already exists

Existing / envisaged participants

Further relevant information regarding your application

Did you consultat your Geo.X coordinator? (obligatory)

Yes

How did you learn from this call?

Geo.X website

Mailing list

Geo.X coordination team

Newsletter

Colleague

Others

If others

(4) Declaration and Submit

Declaration

I declare that the given information is true and that Geo.X is allowed to store the data for purposes of application/admission.

Data Protection

I hereby agree that my personal data is collected, processed and used only for the purpose of processing my application to the Geo.X Head Office. A storage of personal data beyond the processing period takes place only to the extent necessary for accounting purposes. Data without allowing a direct reference to the person are used for statistical evaluation. The revocation is possible at any time with the Geo.X Head Office.
PRIVACY POLICY

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