AFS-II
The Annual Foundation School (AFS)-I
Funded by
National Board for Higher Mathematics
Chennai Mathematical Institute, Chennai
3-30 December, 2009
Application for Participation in AFS-1
(Last Date of Application: 4th Sept. 2009.)
The list of selected participants will be displayed on the website:
www dot bprim dot org/atm,
on 11th Sept. 2009.
| NAME (in capitals): |
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| Date of Birth: |
Gender(M/F): |
| Scholarship(s) held: NBHM/ CSIR/ UGC/ Others: |
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| Area of interest: |
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| Postal Address: |
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| e-mail: |
phone: |
| Current course 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):
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| Any other-relevant information: | |
Academic record:
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University/ Institute |
Year of passing |
Overall % score |
% in Mathematics |
| S.S.C. |
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| B.Sc. or B.A. |
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| M.Sc. or M.A. |
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(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 Teacher
With Institute Seal
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Mail this application to:
Convener
Clare D'Cruz,
Chennai Mathematical Institute
Plot H1, Sipcot IT Park,
Padur PO, Siruseri 601 103
Phones: 044-2747 0226-0229, Fax: 044-2747 0225
email: clare.cmi at gmail.com