1 Contact Address 4.2 City 4.3 Street, No. 3 4.3 Telephone 4.4 Telephone 4.5 Telephone 4.6 Telephone — Date of birth and sex 4.7 Telephone (cancelled) 4.8 Telephone (cancelled) 8. CONFIRMATION OF APPLICATION 3 9. STATUS IN THE UNITED STATES OF AMERICA 3 10. CONFIRMATION OF APPLICATION OF MEMBER OF THE RUSSIAN ARMY 3 11. APPLICATION IN THE FORM OF AN ORIGINAL DOCUMENT 3 12. PAYMENT REQUIRED 4.1 IN THE TOTAL FORM (EXCL. CERTAIN INNOCENT CURRENCIES) 4.2 IN THE TOTAL FORM (EXCL. CERTAIN INNOCENT CURRENCIES) 4.3 IN THE TOTAL FORM (EXCL. CERTAIN INNOCENT CURRENCIES) 4.4 IN THE TOTAL FORM (EXCL. CERTAIN INNOCENT CURRENCIES) 4.5 IN THE TOTAL FORM (EXCL. CERTAIN INNOCENT CURRENCIES) 4.6 IN THE TOTAL FORM (EXCL. CERTAIN INNOCENT CURRENCIES) 3.1 Payment must be in U.S. dollars. 3.2 If you have already paid for the course by a previous application, this time you will not pay by submitting an additional application. 3.3 Upon confirmation, we will request that you provide us with an original or a copy of all the documentation for verification which may not be included in the application forms you submitted in 2009. 3.4 In addition, we shall ask you to provide us with the following information: 3a. Name (Optional) 3b. Address 3c. City of residence with state (optional and can be any one of the places selected in the forms which you submitted in 2009) 3d. Postal code 3e. Phone number 3f. E-mail 3.4a. If you are married, you MUST indicate the gender of your spouse. 3.5 In the total forms you submitted in 2009 you indicated: 3.5a. If your student visa has status of temporary residence under category “C” 3.5b. If your student visa has status of residence under “B” (Student) 3.6 You must indicate whether you hold a U.S. citizen visa. 3.
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SUMMER FIELD COURSE IN INVERTEBRATE ZOOLOGY 2012 APPLICATION FORM 1. PERSONAL DETAILS 1.1 Name 1.2 First Name 1.3 Other Names 1.4 Date of Birth (d/m/y) 1.5 Sex 1.6 Place of Birth 1.7 Citizenship 1.8
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