------APPLICATION FORM

Please complete the following application form and arrange a letter of
recommendation. These should be e-mailed to 
<pschool-rgst2010 "at" cps-jp.org> by September 25, 2009. If you don't
receive an e-mail for acknowledgment of your application within
several days, please contact <pschool-info2010@cps-jp.org>.

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Application for participation in the CPS International School of  
Planetary Sciences, January 4 - 9, 2010

1. Family Name:

2. Given Name:

3. Gender: Male/Female

4. Nationality: (As written in your passport)

5. Status/Position: M1/M2/D1/D2/D3/postdoc for domestic applicants;
master's or doctoral (Ph.D.) students/postdocs for foreign applicants;
name of position for others; 

6. Affiliation: (Department and Institution)

7. Postal address:

8. E-mail address:

9. Phone number:

10. FAX number:

11. Financial support: Not required/Required

  If required, then
  11a. Estimate of transportation expenses (in JPY/USD/EURO):

  11b. Departure from: (If you fly, which airport?)

  11c. Arrival at: (If you fly, which airport?)

  11d. Airline Company (If you fly):

  11e. Arrival and Departure Date in and from Japan (immigration day)

  *Please attach a written estimate from your travel agency or air  
   company.

12. Preferred room type: select one from the following;
(a) a Japanese-style room w/o tub/shower for share (approx. 45,000 JPY), 
(b) a Japanese-style room w/ tub for share (approx. 47,000-57,000 JPY), 
(c) a Japanese-style room w/o tub/shower for single use (approx. 60,000 JPY), 
(d) a Japanese-style room w/ tub for single use (approx. 62,000 JPY).

13. Vegetarian: Non-vegetarian/Lacto-ovo vegetarianism/Lacto  
vegetarianism/Ovo vegetarianism/Veganism

14. Food allergy, if any. 

15. Smoking: Non smoker/Smoker/Heavy smoker

16. Poster presentation: Yes/No

17. Your current research subject(s) or interests (about 400 words):

18. Reference Information for students and postdocs: 
Names, affiliations, and e-mail addresses of three persons 
whom we could consult about your qualifications 
(e.g., a supervisor of your thesis; a person in charge of your position)

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19. Letter from one of the referrer for students and postdocs: 
*Please ask one of the three referrer of item 18 to send a brief
 letter of recommendation with the following information separately to
 the Organization Committee <pschool-rgst2010@cps-jp.org> by the
 deadline of application.

 19a  Referrer's name, position and affiliation, e-mail address.
 19b  Applicant's name, position and affiliation.
 19c  The circumstances under which you have known the applicant.
 19d  Rate of the applicant's past performance relative to others 
      you know in general. 
 19e  Brief comment as to personal characteristics such as motivation,
      maturity, potential in the fields of planetary atmospheric
      science, etc.
 19f  Summery Evaluation : overall evaluation of the applicant's
      suitability for CPS Planetary School;
      Excellent, Good, Normal, Below Normal, Unacceptable

------END of APPLICATION FORM