AIS

Advanced Instructional School

Algebraic Geometry

Funded by National Board for Higher Mathematics
Bhaskaracharya Pratishthana, Pune
30 Nov. - 19 Dec. 2009

Application for Participation in AIS in Algebraic Geometry (2009)
(Last Date of Application: 10th Sept., 2009)
The list of selected participants will be displayed on the website: www.bprim.org on 17th Sept., 2009.

NAME (in capitals):

Date of Birth:

Gender(M/F):

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)

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):

Any other-relevant information:

Academic record:

	University/ Institute	Year of passing	Overall % score	% in Mathematics
S.S.C.
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

Mail this application to:

Prof. S. A. Katre
Coordinator, AIS in Algebraic Geometry
C/o, Bhaskaracharya Pratishthana
56/14, Erandavane, Damle Path,
Off Law College Road,
Pune - 411 004, India.
phone: 91 020 25434547, fax : 91 020 25434547 email: aisbim at gmail.com