KITP

Please Note: Prior to completing this form you must have accepted your invitation to the program and arranged for your housing.

Your response will be seen only by relevant KITP staffers; however, if you feel that your request contains confidential information and prefer to discuss your situation with one person only, please call or email Michelle.

We will try to respond to your request as quickly as possible. As there is some codependency built into the situation (our needing to know how much housing costs in order to make a determination while a scientist needs to know about the extra funding before committing to housing) some time for additional correspondence and information gathering may be required.

The Rice Family Fund is made possible through the generosity of Drs. Ann and Myron Rice.

If you have any questions, please email Michelle.

Personal information

Program Name: *	- Select -A Universe of Black Holes (bholes13)Bits, Branes, Black Holes (bitbranes12)Chirps, Mergers and Explosions: The Final Moments of Coalescing Compact Binaries (chirps12)Control of Complex Quantum Systems (qcontrol13)Cooperation and the Evolution of Multicellularity (multicell13)Deep Time: How did the early Earth become our modern world? (earth12)Exploring TeV Scale New Physics with LHC Data (lhc13)Fluid-Mediated Particle Transport in Geophysical Flow (geoflows13)Frustrated Magnetism and Quantum Spin Liquids: From Theory and Models to Experiments (fragnets12)Fundamental Science and Applications of Ultra-cold Polar Molecules (coldmoles13)General Members 11-12 (gm_1112)General Members 12-13 (gm_1213)Hunting for Dark Matter: Building a cross-disciplinary, multi-pronged approach (dmatter13)Knotted Fields (Minipgm) (knots_m12)New Quantitative Approaches to Morphogenesis (morpho13)Physical Principles of Multiscale Modeling, Analysis and Simulation in Soft Condensed Matter (multiscale12)Physics and Mathematics of Cancer (cancer12)Primordial Cosmology (primocosmo13)Quantitative Immunology: Experiments Meet Modeling (Minipgm) (immuno_m12)Quantum Dynamics in Far from Equilibrium Thermally Isolated Systems (qdynamics12)Spintronics: Process in Theory, Materials, and Devices (spintronics13) The name of the program you will be attending.
First Name: *
Last Name: *
E-Mail: *
Visit dates:	The dates you will be here at the KITP. Arrival Date: * Year20102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044204520462047204820492050 MonthJanFebMarAprMayJunJulAugSepOctNovDec Day12345678910111213141516171819202122232425262728293031 Departure Date: * Year20102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044204520462047204820492050 MonthJanFebMarAprMayJunJulAugSepOctNovDec Day12345678910111213141516171819202122232425262728293031

Spouse/Partner Info

Will spouse/partner visit?: *	YesNo
If yes, dates of spouse/partner visit:	Arrival Date: Year20102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044204520462047204820492050 MonthJanFebMarAprMayJunJulAugSepOctNovDec Day12345678910111213141516171819202122232425262728293031 Departure Date: Year20102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044204520462047204820492050 MonthJanFebMarAprMayJunJulAugSepOctNovDec Day12345678910111213141516171819202122232425262728293031
Spouse/Partner Name:

Family Members

Will children visit?: *	- Select -YesNo
If yes, dates of children’s visit:	Arrival Date: Year20102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044204520462047204820492050 MonthJanFebMarAprMayJunJulAugSepOctNovDec Day12345678910111213141516171819202122232425262728293031 Departure Date: Year20102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044204520462047204820492050 MonthJanFebMarAprMayJunJulAugSepOctNovDec Day12345678910111213141516171819202122232425262728293031
Names and Birth date (MM/YYYY) of children:
Will any of your children attend public school in the Santa Barbara area?:	- None -YesNo
Others living with you in Santa Barbara (relative, nanny, au pair, etc.). Please specify Names and Dates of Visit for each person:

Please indicate how much you will need to pay in the following categories, if relevant

Rent in Santa Barbara per month: *
Additional Airfare for family members:
Will you need child care? (if yes, please estimate cost):
Will you need a rental car? (if yes, please estimate cost):
Other:
Are there any other factors that we should know about regarding your family needs?: *

Additional Info

Is it likely that you could rent your home or apply other income to offset some of the expense of your coming here?: *	- Select -YesNo
If so, please indicate approximately how much you might receive:
Are you a U.S. Citizen or permanent resident of the USA?: *	- Select -YesNo
If no, please enter anticipated visa status for this visit so we can determine how best to support you.:

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