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Short Term Training Course on
Molecular Biology Techniques(May 2-14, 2011)
Centre for BiotechnologyMaharshi Dayanand University
Rohtak, Haryana—124 001
Application form
Title - Dr. / Mr. / Mrs. / Ms.First name ……………………………………………………….Surname ………………………………………………………...Educational background ………………………………………..Position ………………………………………………………….Organization …………………………………………………….Address ………………………………………………………….…………………………………………………………………...…………………………………………………………………...City …………………….. State ………………………………...PIN ………………………………………………………………Tel. ………………………………………………………………Mob ……………………………………………………………..E-mail …………………………………………………………..Reason to join this training course: ...…………………………..…………………………………………………………………..…………………………………………………………………..…………………………………………………………………..Payment details: DD No. …………………………………………………………Date …………………………………………………………….Bank ……………………………………………………………
Signature ………………………………………………………..
Application may be sent by post to:The Course Director, Centre for BiotechnologyMaharshi Dayanand University, Rohtak—124 001.Phone: +91-1262-393101; Mob: 09896014951.
E-mail: [email protected]
