Date of Birth (YY/MM/DD): 
Nationality: 
Postal Address:

Telephone:,             Fax: 
E-Mail: 

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

Current Institution 

Area of Research: 

Please list your three recent publications (if any): 

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

Are you Non-vegeterian, Vegeterian   Please specify: 

A limited number of grants to support living and travel expenses of participants from developing countries are available.
Please specify as appropriate:
I am requesting financial support for Travel Local expenses  Both
Please specify the reasons for which the grant is needed:

Father's Name: 
Passport Number: 
Date of Issue (YY/MM/DD): 
Place of Issue: 
Expiration Date: (YY/MM/DD): 
Place Visa To Be Obtained: 
Duration of Stay in Iran: 

IF YOU ARE A PH.D STUDENT OR A POST-DOC, PLEASE ASK YOUR SUPERVISOR OR SENIOR RESEARCHER TO WRITE A RECOMMENDATION LETTER.

Recommendation letter has to be sent to: Farhad Ardalan
E-mail: ardalan@theory.ipm.ac.ir
Fax: +98 - 21 - 228 04 15

• The deadline for registration is:  March 1, 2000.
• The school secretary will contact you before:  April 1, 2000
• For any further information, please contact school secretary, Mrs.Davarpanah
E-mail: iss2000@theory.ipm.ac.ir
Tel: +98 - 21 - 229 09 34, 228 06 92
Fax: +98 - 21 - 228 04 15