HOMI BHABHA CENTRE FOR SCIENCE EDUCATION, TIFR Chemistry Olympiad Exposure Camp
(in collaboration with Tezpur University, Assam)
APPLICATION FORM
Venue:
Department of Chemical Sciences, Tezpur University, Assam Date: November 10 – 13, 2019(Note: This programme is open to teachers teaching chemistry at class X/XI/XII only) Name of the Teacher: Mr / Mrs / Dr /Prof. .………..………...…………
Name and Address of the School/College: .……….…………..……….……
……….
………..………...
Name of Principal:………..……….
Principal Office Phone No:………..……….
Educational Qualification: ……….………
Class at which you teach in your School/Jr. College ..…….……….……….
Duration for which you have been teaching in your School/Jr. College …….………
Areas taught by you: Physical/Analytical/Organic/Inorganic/Biochemistry/General chemistry/All Areas of Interest:
Address for correspondence with PIN..……….………...
………..………
………..…………
Phone Number with STD code (Res.)………(Mobile)………
E-mail ID: ……….……….………..
Involvement in any other educational activity related to the following categories (if yes, present necessary details in one or two lines)
Curriculum development
Affix your recent photograph
HERE
Book writing/Educational material development
Why do you want to attend this camp?
I certify that I have not attended in past any Olympiad exposure camp organised by HBCSE. (Please do not hide any information about previously attended camps. We match your application with previous records.
At any stage if we find that you have provided wrong information, your candidature will be cancelled)
Date………..…Place……….Signature of the Teacher.…………..…
Please make the PHOTOCOPIES of this form as per your requirement. Completed Application form should reach the following address by October 25, 2019.
