A P P L I C A T I O N   F O R M

  for the GULP Int'l Summer School on Advances in Logic Programming
                Alghero (Sardegna), June 24-29,1996
                                
(Return to Gianfranco Rossi - gianfr@prmat2.math.unipr.it not later
than April 20th, 1996)


Surname: ......................  First Name: ......................

Affiliation: .........................

Position: .........................

Address: ..........................................................

 ..................................................................

 ..................................................................

E-mail:.............................. Fax: ........................

Tel.: .........................



I would like to have a:     [ ] single room

                            [ ] double room

Accompanying persons: No. ....
                                                        

I apply for a scholarship covering the participation fee:  Yes  No
(applicants must include a curriculum vitae) 


I would like to sit for an exam at the GULP School:  Yes  No



Date: .................... Signature: ............................