VISITING GRADUATE STUDENT APPLICATION
                      Special Year in Mathematical Biology
                           September 1995-June 1996
                             University of Utah
                         Department of Mathematics


Name:  _______________________________________________________

Home Address: ________________________________________________

              ________________________________________________

University Address:  _________________________________________

                     _________________________________________

Email:  ______________________________________________________

Advisor: _____________________________________________________

Area of Specialization:  _____________________________________

Proposed Quarter:

    _______  Ecology and Evolution (Sept. 27 - Dec. 8, 1995)

    _______  Physiology and Cell Biology (Jan. 3 - March 8, 1996)

    _______  Cardiovascular Physiology and Biofluids (March 25-May 31, 1996)

Current Support:   

                  _____  Grant 
                         
                         (List Principal Investigator
                         _________________________________)
                         
                         
                  _____  Teaching / Departmental Research Fellow
                  

                  _____  Other (please explain)

Support needed to attend:

                  ______ Full

                  ______ Travel Only

                  ______ Travel and Accommodation


Ethnic Background (optional):___________________________________

Please include a one page description of your reason for
attending and two letters of recommendation. Applications
will be be received until 7/15/95 or until positions are
filled.  We expect to notify successful applicants by 7/31/95.

MAIL TO:  Mark Lewis
          Special Year in Mathematical Biology
          Department of Mathematics
          JWB 233
          University of Utah
          Salt Lake City, UT 84112, USA