Arithmetic Geometry

Advanced Training in Mathematics Schools

Workshop on Arithmetic Geometry

Funded by National Board for Higher Mathematics
Venue- IIT, Guwahati
22 - 30 September, 2008
Application for Participation in Workshop on Arithmetic Geometry
(Last Date of Application: 15th July, 2008)
The list of selected participants will be displayed at the ATM Schools website on 22nd July, 2008.

NAME (in capitals):

Date of Birth: Gender(M/F):

Age:

Scholarship(s) held: NBHM/ CSIR/ UGC/ Others:

Area of interest:

Name and Address of the affiliated Institute:

Postal Address:

e-mail:(Please write email address legibly) Phone:

Date of Joining Ph.D. programme:

Current courses of study (M.Phil./Ph.D.):

Names of two teachers who have given recommendations
(to be sent along with the form or by e-mail):

ATM SCHOOLS attended before:

Whether any other workshops in Mathematics attended earlier?

Any other-relevant information:

Academic record:

University/ Institute Year of passing Overall % score % in Mathematics

B.Sc. or B.A.

M.Sc. or M.A.

Other

Signature of the applicant

(To be certified by the Head of the Institute or by a teacher)
Certified that I have verified the records and found the above information correct.

Signature of the Head of the Institute or a Teacher
With Institute Seal

pdf version of the form Mail this application to:

A. Saikia
Department of Mathematics

IIT, Guwahati

Guwahati-781039, Assam.

email: aisiitg0908 at gmail.com

Phone: 0361-2582616, Fax: 0361-2582649