ࡱ>  Vbjbj 8*V 33333GGGG<GHjHHHHHHHYJLH3H33H 33ZH8HfEDG`~#G&F&FHH0HFJM(MLGM3G,hJd<|HHHM :  ECG Atmospheric & Environmental Chemistry Forum, 4 June 2010 Application Form To register for the Forum, please complete the form below and return it together with an abstract of your presentation and registration cheque (if applicable) by 30 April 2010. The meeting is free to members of the ŷAV. The organising committee offers a number of bursaries to ŷAV members to help with reasonable travel expenses. Priority for bursaries will be given to delegates giving a talk or presenting a poster. Please help us spread these bursaries widely by booking advanced fares / using rail cards etc wherever possible. The registration fee is 40/60 for non-ŷAV members (PhD/PDRA) and, unfortunately, travel bursaries cannot be paid to non-members. Numbers for this meeting are limited so early application is recommended. Name:... Status (PhD year / career stage) .... Department, Institution .. ... Postal Address ....... ... Tel. E-mail:.. Any special requirements? ..................... I would prefer to present a poster ( a talk ( Title of presentation: .................................................................... ................................................ ( I am a member of the ŷAV; my membership number is ( I am also a member of the Environmental Chemistry Group ( I am currently applying for membership of the ŷAV (NB this must be completed before the meeting) ( I wish to apply for a travel bursary, estimated travel costs ................. Travel bursaries are only available to delegates who are members of the ŷAV on the day of the meeting. ( I am not a member, Cheque enclosed for 40/60 (PhD/PDRA) payable to ŷAV Environmental Chemistry Group Signed Date Data Protection: After the meeting, we would like to publish a list of talk & poster titles together with the presenters name and affiliation in ECG Bulletin, the 6-monthly publication of the Environmental Chemistry Group, and on the ECG website (www.rsc.org/ecg); if you would prefer not to appear, please tick (. Please attach (and email) an abstract of your research presentation (max side A4). Send the completed form and abstract to: Dr W Bloss, School of Geography, Earth & Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT. Email: w.j.bloss@bham.ac.uk We will confirm successful registrations, talk/poster presentations and bursary awards via email around 14 May 2010. If over-subscribed, preference will be given to postgraduate students and early-career researchers who are ŷAV / ECG members. 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