National Center for Supercomputing Applications
Office of the Director

NCSA/UIUC FACULTY FELLOWS PROGRAM

APPLICATION COVER SHEET

Name:        
                        (Last)                                                  (First)
Social Security Number:
Phone:  (home)(work)
Address:  Office:
               Home:
E-mail Address: 
Web Site URL: 
Home Institution: 
Home Department:
Title/Position:  Tenure Status:
Project Title: 
Abstract: 

I understand that NCSA will only cover appropriate expenses up to the amount awarded by the NCSA/UIUC Faculty Fellows Program.

Signature:  _____________________________ Date:___________________________
                        (Head or Chair of Department)

Signature:  _____________________________ Date: ___________________________
                        (Applicant)

Please complete and mail the signed application cover sheet no later than April 10, 2006 to:

Dr. Radha Nandkumar
NCSA/UIUC Faculty Fellows Program
4102A NCSA-BLDG
1205 W. Clark St.
Urbana, IL 61801

Email ncsasff@ncsa.uiuc.edu for any additional information.