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2nd Ewiem Nimdie International Summer School Application Form

Kwame Nkrumah University of Science & Technology, Kumasi, Ghana

19-31 July 2010
Closing Date for application is 31st March 2010

PLEASE TYPE IN CAPITAL LETTERS (to avoid errors on name tags and attendee list))

Surname

First name

Sex

Male
Female

Organization

Address

City

Postcode

Country

E-mail

Phone

Fax

Mobile

Current field of study

What is your highest education level?

BSc
MSc
PhD

Nationality

Current position

Date of Birth

Departure point

Funding needed

Yes
No

Please provide contact details of a potential referee (advisor/supervisor)

Referee name

Referee e-mail

Referee phone

Reasons for attending (200 words minimum)

Track record (200 words minimum)

Other information

For any additional information contact Dr. Leonard K. Amekudzi, (leoamekudzi@yahoo.com) Department of Physics, KNUST, Ghana, Phone +233-(0)24 7061181 or Dr. Adrian Tompkins, (tompkins@ictp.it), ICTP,Trieste, Italy, Fax: +39 040 2240449, Phone +39 040 224057