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SCIENCE ACADEMIES’ FIFTY-SIXTHREFRESHER COURSE IN EXPERIMENTAL PHYSICS
(11th Feb. -26th Feb. 2014)
DEPARTMENT OF PHYSICS PANJAB UNIVERSITY, CHANDIGARH
Refresher Course is jointly sponsored by the Indian Academy of Sciences, Bangalore; Indian National Science Academy, New Delhi; The National Academy of Sciences India, Allahabad.
Course Director – Professor R. Srinivasan Course Coordinator – Professor D. Mehta
APPLICATION FOR REFRESHER COURSE IN EXPERIMENTAL PHYSICS
(INCOMPLETE APPLICATIONS WILL NOT BE ENTERTAINED) To
The Course Coordinator,
56th Refresher Course in Experimental Physics, Department of Physics,
Panjab University, Chandigarh – 160 014
e-mail: [email protected], Phone: +91 9815973101
Sir,
I wish to join the 56th Refresher Course in Experimental Physics to be held from 11 Feb. to 26 Feb. 2014. I shall abide by the terms and conditions of the course / programme and will attend each and every session and will participate in every possible way.
2 My particulars are given below:
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1. Name : Dr./Ms./Mr. ___________________________________________
Male/Female ______________
2. Date of Birth : ______________
3. Qualifications : ___________________________________________
4. Designation : ______________
5. Status : Temporary / On probation / permanent : ______________
6. College / University: ___________________________________________
7. Office Address : ___________________________________________
_________________________________________________________
Ph. No. ______________
8. Residential Address: ___________________________________________
____________________________________________________________
Ph. No. ______________
9. Subject: ______________
10. Area of Specialization : ______________
11. Length of Service : ______________
12. Teaching Experience :
Undergraduate level : ______________
Postgraduate level : ______________
13. Shortest Route of Journey:
14. Do you need hostel accommodation ? Yes / No.
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15. Details of the Refresher Courses/ Seminars / Workshops relevant to the subject attended : Attach separate sheet if required
16. Publications (if any) Attach the list of publications / papers presented in conferences.
The particulars given above are correct to the best of my knowledge
Yours faithfully
Date : (Signature of the Applicant)
ENDORSEMENT BY THE H.O.D/PRINCIPAL The Course Coordinator,
56th Refresher Course in Experimental Physics,
Department of Physics, Panjab University, Chandigarh – 160 014
Sir,
I am forwarding herewith the application of Mr./Ms. ________________
__________________ who is on the teaching staff of the Department/College for participation in the Refresher course in Experimental Physics to be held at Panjab University, Chandigarh from 11 Feb. – 26th Feb. 2014.
Date ...
Signature of the H.O.D/ Principal with Seal of the Department/ College
Applications to be sent to: Prof. Devinder Mehta
Course Coordinator, 56th Refresher Course in Experimental Physics, Department of Physics, Panjab University, Chandigarh – 160 014
e-mail: [email protected], Phone: +91 9815973101
