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RENCONTRES DU VIETNAM - INSTITUTE OF PHYSICS & ELECTRONICS, HANOI --------------- |
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REGISTRATION FORM
Full Name:...................................................................................
Date of birth:......................Male/ Female:............................................
Highest Univ. title, and date:...............................................................
Academic position:........................................................................... Professional address:........................................... .........................................................................................
E-mail:...............................Phone:................... Fax.......................... Private address:............................................................................ ......................................................................................... Mailing address (please, underline an appropriate address) : professional / private Detail of physics education (this is used by the organisers to better target the level of courses): underline (or click) the relevant items and/or add relevant elements
- Quantum Field Theory:......................................................................
- Mathematical Physics:.....................................................................
- Condensed Matter Physics:.................................................................
- Particle Physics:.........................................................................
- Statistical Physics:......................................................................
- General Relativity and Gravitation:....................................................... Professional activities (please, use additional pages if necessary):
- Research subject..........................................................................
- Teaching activities....................................................................... - If you have publications, please list those you consider most relevant ..................................................... Proficiency in English:..........excellent..........good.............fair...........poor............. Senior Scientist recommending the participant:
Full Name:..................................................................................
E-mail:..................................Phone:.............................................
General opinion: ...........................................................................
Please return the completed form before 10 November 2004 (by post, or by e-mail (not valid for free accounts), or by fax) to:
Vietnam School of Physics |