ESO SCIENTIFIC VISITOR PROGRAMME IN GARCHING                              

	Application Form    
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1. Personal Information:

	Name              
	Date of birth              
	Nationality              
	Degrees held   

2.  Present affiliation and contact address (mail & e-mail)  

3.  Career path to date  

4.  Scientific interests and main recent publications

5.  Proposed visit to ESO      

	5.1 Desired dates and length of the visit
	5.2 ESO staff member or fellow with whom the visit has been coordinated
	5.3 Other ESO staff member(s) or fellow(s) with whom you would like to collaborate during your visit
	5.4 Purpose of the visit, including work-plan
	5.5 Specific outcomes of the proposed visit
	5.6 Other sources of financial support beside your salary at your home institution during your visit
	5.7 Accompanying persons
	5.8 Would you like to give a (informal) talk at ESO? If yes, please suggest a topic
	5.9 Have you been a scientific visitor in Garching in the two calendar years prior to this visit?   


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ONCE COMPLETED, PLEASE FORWARD THE FORM TO: VSC-chair@eso.org