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UNIVERSITY/FACULTY LETTERHEAD

To

Head of Research Center for Nanosciences and Nanotechnology Jl. Ganesa No. 10, Bandung.

Dear Sir or Madam,

I am the undersigned :

Name : <Name of Faculty/School Dean>

Position : <Dean of Faculty/School Dean, University of….> University :

Department : Address :

Regarding the upcoming event “Summer School Nanosciences : Fundamental and Application Emphasizing in Nanomedicine” held by Research Center for Nanosains and Nanotechnology at Institut Teknologi Bandung, Indonesia on 24th July – 05th August 2017, hereby submit a letter to request for waivers for the following student :

Name :

Student Number : University :

Department : Place and Date of Birth :

Thank you very much for your consideration upon this request.

Best regards,

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