Application form

Fill out all the required fields below. Provide the names of two present CIMPA members (your sponsors) who will support your application. Then your application will be sent to the Governing Board for the purpose of a presentation at the next CIMPA General Assembly. Full applications must be received at least 3 weeks before the General Assembly.

Family Name

Given Name

Gender

Institution

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Present position

Select one sponsor in the list

Select another sponsor in the list

Main mathematical interests

Motivations to become a member