Name:
Institution:
Address for correspondence:
e-mail address:
Estimated travel costs (give details):
Do you wish to give a 20 minute contributed talk?
Title of Talk (if applicable):
Brief statement of research interests:
Brief statement of support from supervisor:
Signature and Name of Supervisor
I wish to apply for financial support to attend the annual meeting of the British Logic Colloquium, 6-8 September 2001.
Signed
Date
You will be notified of the success of your application by e-mail.