KITP Program Affiliate Nomination Form

NOTE: This form is not to be completed until after you have received and accepted an official invitation to participate in one of our programs.

If you have any questions, please contact the Program Manager.

*fields with asterisks must be completed.

Advisor (or Mentor) Information
I have been officially invited for the following dates

Please select both your start and end dates in the datepicker or from the select boxes.

Start Date *
End Date *
Affiliate (Student or Postdoc) Information
I would like my Affiliate's visit dates to be

Please select both your Nominee's start and end dates in the datepicker or from select boxes. The minimum stay for affiliates is three weeks; unless you have made other arrangements with the organizers, this period must be within the period of your participation.

Start Date *
End Date *
Affiliate Recommendation
Type the characters you see in the picture; if you can't read them, submit the form and a new image will be generated. Not case sensitive
Enter the characters shown in the image.