Advanced Training School in Mathematics

Workshop on Topology of Manifolds

(Sponsored by National Board for Higher Mathematics )

1 - 13 February, 2010


Application form
(Last date of application 4th Dec. 2009).




NAME (in capitals):
Date of Birth:     Gender(M/F):
Age:
Scholarship(s) held: NBHM/ CSIR/ UGC/ Others:
Area of interest:
Name and Address of the affiliated Institute:
Postal Address:
e-mail:(Please write email address legibly) Phone:
Date of Joining Ph.D. programme:
Current courses of study (M.Phil./Ph.D.):
Name of one teacher who has given recommendation
(to be sent along with the form or by e-mail):
ATM SCHOOLS attended before:
Whether any other workshops in Mathematics attended earlier?
Any other-relevant information:
Academic record:
University/ Institute Year of passing Overall % score % in Mathematics
B.Sc. or B.A.
M.Sc. or M.A.
Other


Signature of the applicant


(To be certified by the Head of the Institute or by a teacher)
Certified that I have verified the records and found the above information correct.


Signature of the Head of the Institute or a Teacher
With Institute Seal

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Mail this application to:

Prof. P. Sankaran
Convener, ATMW in Topology of Manifolds
Institute of Mathematical Sciences
CIT Campus, Taramani, Chennai 600113
e-mail: sankaran at imsc.res.in
Phone: (O) 044-2254-3211 (M) 09940139682.
Fax: 044-2254-1586