North-East Summer Workshop in Mathematical Analysis
and Probability 2017
July 06 – July 10, 2017
Manipur University, Imphal
Supported by
Indian Statistical Institute
APPLICATION FORM
1. Name in Block Letters:
2. Gender (Male/ Female):
3. Name of the College/University:
4. Address for correspondence (with mobile/phone no.):
5. E-mail address:
6. Academic qualifications:
Examination
% of Marks (Maths)
Remarks (if any)
M.Sc 1st year
M.Sc 2nd year
M.Phill/Ph.D
Others
7. Present Course of Study (e.g. M.Sc 1st year):
8. Present Position and experience :
9. Have you participated in any mathematical activities? If yes, please give some details.
10. Accommodation required (Yes/No):
Signature of the Applicant (with date)
Note: Please fill up application form send it to
Prof. T Ibungochouba Singh, Department of Mathematics, Manipur University.IndoMyanmar Road, Canchipur – 795003, Imphal, Manipur.
E-mail: [email protected]
Contact No: 9862199257
Last date of submission of application form is May 25, 2017.
Also please attach a letter of recommendation from the Head of the Department.