Center for Multiscale Plasma Dynamics

And the

Center for Magnetic Self-Organization

Winter School 2009

January 5-10, 2009 – UCLA Department of Physics and Astronomy

“Common Themes in Space, Astrophysical and Laboratory Plasmas:

Dynamo, Heat Transport and Collisionless Shocks”

A P P L I C A T I O N

Name (first)______________________________ (last)_______________________________________

Address:____________________________________________________________________________

City:__________________________________Country_______________________________________

Phone #:_______________________________e-mail:_______________________________________

Institution:__________________________________________________________________________

Years in School:________Advisor:______________________________________________________

Research Interest:____________________________________________________________________

Requesting Support:__________ Need Housing_________________Gender____________________

PLEASE PRINT

Please review your application information. If any information is incorrect, please send corrections to the

Winter School administrator at cmpd@physics.ucla.edu. If you are requesting travel support, your research

advisor must send a letter of recommendation to cmpd@physics.ucla.edu.

Please fill out and fax to: 310-267-0244 ATTENTION: Mary Jo Robertson

Or e-mail to cmpd@physics.ucla.edu