IPM Cosmology School and Workshop

June 2 - 9, 2007
Tehran, IRAN

Deadline for Applications: March 15th, 2007


Name (First / Middle / Last

Postal Address

Telephone       Fax 

Professional Status Ph.D Student  Ph.D   Post-Doc   Faculty

Current Institution 

Area of Research 

Do you wish to present a talk Yes No
If Yes, Please give the title

Are you Non-vegetarian Vegetarian   Please specify: 

A limited number of grants for local expenses and travel fare for participants from developing countries is available.
Request for financial support :
Travel fare Local expenses Both


Place of Birth: City   Country 
Date of Birth (YY/MM/DD
Sex Male Female
Present Nationality 
First Nationality
Father's Name
Ancestor's Name (for Arabic Nations)
Passport Number 
Date of issue (YY/MM/DD
Place of issue 
Expiration Date (YY/MM/DD
Place visa to be issued 
Duration of stay in Iran 
Last visit of  Iran 

                                                            E-mail: icsw (at) theory.ipm.ac.ir
                                                            Tel: +98  (21)  22 29 09 34, 22 28 06 92
                                                            Fax: +98  (21)  22 28 04 15