PARTICIPATION APPLICATION FORM

39th INTERNATIONAL NATHIAGALI SUMMER COLLEGE ON PHYSICS AND CONTEMPORARY NEEDS, NATHIAGALI, PAKISTAN 04th 16th August, 2014
Indicate the scientific activity of interest: Activity-I (04th 09th August, 2014) a. Accelerator Technology and its Applications b. Activity-II (11th 16th August, 2014) Plasmonics and Metamaterials

Activity-III (04th 16th August, 2014) c. 5th Workshop on Tokamak

Name: (Underline Surname) .. Father's/Spouse Name: .....Marital Status .......... Date of Birth .................. Place of Birth ............ Nationality .... Official Address:

Phone: Fax: E-mail: ................ Home Address:

Preferred Mailing Address (Please tick):

Office

Home

FOR OVERSEAS APPLICANTS ONLY Passport No: Expiry Date: . Education (Masters Degree and above): Institution attended Period (Years) to to to Degree obtained/Subject . .... .... Date/Place of Issue: ... Nearest Departure Airport:

Title of thesis: M.Sc. /M.S.: Ph.D.: Previous and current scientific and academic responsibilities: Institution Period (Years) to to to

Responsibilities/Position: . .... ....

Work done during the last five years and current field of interest: (Please give a 50-words summary and enclose list of publications)

Title of paper / poster to be presented (if any):

Travel expenses required

Half

No

Previous Nathiagali Summer Colleges attended: (Topic & Year)

Any medical problems:

Undertaking If selected, I will participate in the Summer College for the entire duration offered to me

Signature:

Please Don't Forget To Enclose: 1. Two recent photographs 2. List of publications during the last five years.

Deadline for receipt of requests: 31st March, 2014 Mailing Address: Dr. Syed Javaid Khurshid Executive Secretary International Nathiagali Summer College, PAEC, P.O. Box 1114, Islamabad, Pakistan Fax (+92-51) 9208533/9204908 Email: insc@comsats.net.pk