Application Form
Personal & Contact I
nformation
Title
Miss
Ms
Mr
Mrs
Dr
First Name
Middle Name
Last Name
Phone
E-mail
Passport series and number (for University pass)
Status & Affiliation
Your status
Bachelors student
Masters student
PhD student
Researcher
Industry representative
Other
Affiliation(s)
Country
Participation Details
Type of attendance
School + Conference
Conference only
School only
Presentation title
Abstract
Motivation letter
Your CV
Visa
Visa required?
Yes
No
How did you hear about Petersburg Quantum Weeks?
Additional comments
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