ATML - Complex Analysis

Advanced Training in Mathematics School for Lecturers (ATML)

in Complex Analysis

(Funded by National Board for Higher Mathematics)

14 - 26 th May, 2007

Application for Participation in ATML-Complex Analysis (2007)
(Last Date of Application: 26th March 2007)
The list of selected participants will be displayed on the website: www dot bprim dot org, on Monday, 2nd April 2007.

NAME (in capitals) First/Middle Initial/ Last:

Date of Birth:

Gender(M/F):

Age in years as on 1 May 2007 :

Name of college/University where employed:

Is the position permanent ?

Date of Joining as a lecturer:

Date of passing NET/SET Examination (Attach copy of certificate)

Email address:

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

Areas of interest:

Postal Address (in Capital Letters, with PIN-code):

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

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

Whether any workshops in Mathematics attended earlier?

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.

Signature of the applicant

Signature of the Principal/Head of Dept.
With Institute Seal

Mail this application to:

Coordinator, ATML-CA
Bhaskaracharya Pratishthana
56/14, Erandavane, Damle Path,
Off Law College Road,
Pune - 411 004, India.

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phone: (91) 020 25434547
fax : (91) 020 25434547
email: bhaskara_p@vsnl.com
visit us: www.bprim.org