HOMI BHABHA CENTRE FOR SCIENCE EDUCATION, TIFR
Physics Olympiad Teachers Exposure Camp
February 20-24, 2017
APPLICATION FORM
Name of the Teacher : Mr / Mrs / Dr /Prof. ………..…….………..………..……
Name and Address of the School/College:.……….…………..………..…………...
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Education: ……….……….…
Subjects you teach in your School/College :...……..…….……….…….………...
Address for correspondence with PIN :………..……..………....………...
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Phone Number with STD code. (Res.)………...
(Mobile)………..……….
E-mail ID:……….………..
Have you ever attended Olympiad Exposure camp in any subject at HBCSE? : YES/NO
If yes then please specify subject and month-year of the camp attended: ...
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 20, 2016.
---(You may cut here for address) ---
DR. PRAVEEN PATHAK
HOMI BHABHA CENTRE FOR SCIENCE EDUCATION Tata Institute of Fundamental Research
Near Anushaktinagar Bus Terminus, V. N. Purav Marg, Mankhurd, MUMBAI - 400088
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