HiPC 2014 Student Travel Scholarship Form

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Local or Out-station Student *

Are you studying in Goa?

Local

Out-Station

First/Given Name *

Last name/Surname *

Email Address *

Homepage URL

Address Line 1 *

Address Line 2

Address Line 3

City *

State

Country *

Postal Code

Enter the name of the current institution that you are presently studying in *

Enter the Degree/Program that you are enrolled in. *

Enter your subject/Major *

Year and Semester of Study *

GPA/Percentage of marks so far. *

Rank in class *

Research interests *

Mention about 3 areas that you are interested in.

Name one faculty member who knows about your status. *

This could be your current advisor.

Mention the designation of the above faculty member. *

Mention the email address of the above faculty member. *

Mention any other higher education institution you have attended in the last four years.

Mention the degree obtained at the above institution including specialization.

Mention your CGPA/Percentage at the above institution.

Do you have any publication in HiPC 2014, including the Student Research Symposium.

Yes

Clear selection

Mention the details of the publication in HiPC 2014 including paper title, and list of authors.

Did you attend any conferences/academic events before HiPC 2014? Mention 2-3 events if so.

List of publications (other than in HiPC 2014)

Mention any honors/awards that you received and that can help your application.

Are you a member of any professional societies such as ACM/IEEE. Provide the name of the society and membership number also, if so.

Mention any other academic achievements that help your application.

Briefly state your interest in attending HiPC 2014. *

Submit

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