| Gender | Male
Female
|
| Family (Last) name (*) | |
| First name (*) | |
| Arrival date (dd/mm/yyyy) | |
| Departure date (dd/mm/yyyy) | |
| (for those of you who need to interrupt your stay) |
| Intermediate arrival date (dd/mm/yyyy) | |
| Intermediate Departure date (dd/mm/yyyy) | |
|
| Total number of nights in Potsdam | |
|
| We hope to cover your accomodation expenses (unfortunately probably
without a per diem) but since we have very limited funding, we encourage you to apply to other funding sources, please let us know if you nevertheless do need financial support for travel expenses: |
| Financial Support | |
|
| Towards travel expenses | |
| Train fare | |
| Plane fare | |