5th IAPT NATIONAL STUDENT SYMPOSIUM ON PHYSICS

Indian Association of Physics Teachers

and
Department of Physics, Panjab University, Chandigarh

10-12 November 2017

REGISTRATION FORM

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Abhishek Davda
Name: _____________________________________________________________________

Christ College, Saurashtra University, Rajkot

Class, University / College: _______________________ _____________

A/403, Shilpan Villa society; O/P IOC colony

Address for correspondence: ___________________________________________________
Rajkot-360005
___________________________________________________________________________
9879566230
Mobile: ________________ Abhishek97.davda@gmail.com
Tel: ___________________ Email _______________________

Tick one: I would like to i) make ORAL presentation at the symposium

ii) make POSTER presentation at the symposium
iii) only attend the symposium

I need travel support: Yes No

Accommodation required: Yes No 10 nov

from _______________ 12 nov
to_________________

Did you attend earlier NSSP? (If yes, Tick) 2014 2015 2016

ATTESTATION*

This is to certify that Mr. /Ms. ________________ is a

bonafide student of __ ____ Class of ____________
__________________ (Department/College/Institution)
*In order to give opportunity to students from all over India and due to logistic reasons at our
end, Maximum of 4 students (of all years of B.Sc and M.Sc) from one department / College /
Institute shall be selected. Head of the Dept. / Principal are requested to make sure to
recommend only Four applications in total.

Signature of the Head of the Department/Principal with Seal