Application Form Summer Workshop

Summer Workshop at Computer Science & Engineering Department
There are three(3) workshops being conducted in the department of CSE. Please indicate the specific workshop that you are applying to .

This summer workshop is specially intended to promote post-graduate education and research in India. Hence you should apply only if you are planning to pursue higher education in India. Participants in this program are obligated to appear in GATE 2011 (or earlier).

APPLICATION FORM

Deadline: 26th February, 2010

ATTENTION!
YOU MUST COMPLETE ALL THE FIELDS OF THE FORM!

Once you press the "submit" button, the completed form will be forwarded electronically to the Summer Workshop organizers.
Any column of the form should not be kept blank; you should print it, sign it, and send it to the Coordinator, Your form will be processed only on receipt of the hardcopy along with the supporting documents.
If you do not receive confirmation of receipt of the application form by e-mail within 15 days, please contact the Coordinator
CSEWS 2010,
Dept of Computer Science & Enginnering,
IIT Delhi Hauz Khas New Delhi 110016
( csesw@cse.iitd.ac.in and vandana@cse.iitd.ac.in ) .

Last Name:		Firstname:
Sex :		Date of birth (dd/mm/yyyy):
Place of birth:		Nationality:

Permanent
Address:

Pincode:		City:
Tel:		Fax:
Email:

Address for Communication:

Pincode:		City:
Tel:		Fax:
Email:

University of graduation:

Expected Graduation date:

Discipline:

	CGPA / %age	Rank	Class Size
Academic Performance upto 4th/5th Semester:

Course	Marks	Highest Mark in Class
Digital Electronics
Computer Architecture
Microprocessors
Data Structure
Linear Algebra

Year of GATE Exam 2011?
Which workshop are you interested for?

Describe your interest in and how you would benefit from this workshop (text only, no figures, 100 words) :

Describe your educational and career goals(text only, no figures), 100 words :

Details of the Instructor providing the reference:

Name:

Institution:

Position:

Address:

Email

Course taught to the Student:

Please submit a signed letter of recomendation from the course teacher mentioned above along with the hardcopy.

I declare the aboveinformation to be accurate and understand that any misrepresentation may be a cause for refusal of admission to the program..

The hard copy of this form, duly signed (alongwith the letter of recommendation ), must reach the Coordinator by 26 February, 2010.

Signed:

Date: