Translation of Headings of French application Please send 3 copies

Translation of Headings of French application
Please send 3 copies to Professor Vincent Resh, Dept. of Environmental Science, Policy and
Management/Insect Biology, 201 Wellman Hall, UC Berkeley, CA 94720. All photographs have to be
originals (no photocopies). The application can be filled out in English.
REFERENCE DU DEMANDEUR: information about the applicant
NOM: Last name
Prenom: First name
Date et lieu de naissance: Date and place of birth
Profession: Occupation
Situation de famille: Marital Status
Nationalite: Nationality
Adresse: address
Domicile: Home
Professionnelle: Work
Titres: Title
Travaux effectues: Accomplishments
Publications: Publications
P2
TITRE DU PROGRAMME: Title of the program
ORGANISME ET LABORATOIRE RESPONSABLES DU PROGRAMME: Organization and
sponsoring laboratory of the program
ADRESSE: address
RESPONSABLE SCIENTIFIQUE: scientific coordinator (answer: your
name or that of major professor)
AUTRE (S) ORGANISME (S) PARTICIPANT AU PROGRAMME: other
participating organization of the program
P3
OBJECTIFS DE LA RECHERCHE ET RESULTATS ATTENDUS: objectives or
research and expected results
INTERET EVENTUEL POUR LA POLYNESIE FRANCAISE: possible goals at
the French Polynesia
UTILISATEURS EVENTUELS: perspective users
PUBLICATIONS ENVISAGEES: possible publications
P4
SITUATION DU SUJET DE RECHERCHE: Location of the subject of
research
Ile (s): Island (s)
Terrain
(s): Land (s) (Identite du proprietaire) (Owner's
identity)
PERSONNEL SCIENTIFIQUE AFFECTE AU PROGRAMME: Scientific personnel
in the program
NOM: name
DISCIPLINE QUALIFICATION: discipline, qualification
ORGANISME: organization
TEMP PREVU (en mois chercheurs): anticipated duration
(months devoted to research)
MOYEN TECHNIQUES UTILISES technical methods used
P5
PROGRAMME DES TRAVAUX: plan of research
(decrire les principales phases de la recherche avec
reference a la methodologie retenue): (describe the principal phases of
the research with references to the methodology used)
ECHEANCIER: timetable
Commencement des travaux: beginning work
Etape (s) importante (s): important stages
Achevement prevu: achievements predicted
P6
RENSEIGNEMENTS FINANCIERS: financial information
Cout du Programme: cost of the program
Fonctionnement: operation
Equipement: equipment
Origine du financement: sources of financial support
RELATIONS / COORDINATION
En Polynesie Francaise:
(answer: John Boland and Debbie Woodward, Resident Directors, Richard
Gump South Pacific Biological Research Station of the University of
California, Berkeley)
Exterieur a la Polynesie Francaise : (answer: V.H. Resh,
Professor of Entomology, UC Berkeley)
P7, leave these blank
RESERVE A L'ADMINISTRATION
AVIS DES ORGANISMES CONSULTES
AVIS DE LA MAFIC
DECISION DU HAUT-COMMISSAIRE
Please Note:
When you are at the UC Station please be sure to visit the
French Research Station, which is about three miles away. They
have excellent marine collection available, a library, reprints of
research done at that station, and they offer a seminar series.
There are also several excellent scientists working there (who may
or may not be there at the time of your visit). We are anxious to
establish collaborative research projects between scientists at
the two stations.