Maintenence'; $connection = mysql_connect ("tdsplanet.com","maritrae","webappz") or die ("Cannot make the connection"); $dbc = mysql_select_db ("ebay_sites", $connection) or die ("Cannot connect to database"); $sql_query = "select * from ebay_sites.LIST"; $result = mysql_query($sql_query); while ($row = mysql_fetch_row($result)) { $count++; $site = trim($row[0]); echo 'Guest Site ' . $count . ''; echo "\n"; } echo 'Site91'; echo '
Main   |   Main2 '; exit; } ?> CBMS Registration and Application for Financial Support Form

CBMS Registration and Application for Financial Support Form

Please enter the required information in the fields below to register to the CBMS conference. Indicate if you want to apply for financial support, and if so, enter your estimated budget. A confirmation message with payment instructions will be sent to the provided email address. Any questions regarding the registration process should be sent to cbms@pstat.ucsb.edu. Graduate students should arrange for a short recommendation letter from their adviser to be sent to this address.

First Name:
Last Name:
Title:
Home Institution:

Address Line 1:
Address Line 2:
City:
State:
Zip/Postal Code:

E-mail address:
Contact Number:

Research Area:

Do you wish to apply for financial support: Yes No

If yes, please indicate an estimate for the amount needed:


Please give a short description of your interest in the conference:

Upload your curriculum vitae: