Registration form for Training Program - 2017 / 2018

Please select any ONE course that you would like to attend *

December 12-15, 2017

January / March 2018

Flow Instrument (that is available in your organization) *

We will try to accommodate you on this instrument during the training, as per available slots.

First Name of the Applicant *

Last Name *

Gender *

Male

Female

Title / Position *

Department / Division *

Organization Name *

Organization Type *

Academic

Non-academic

Organization Address:

Street Address *

City *

State *

Pincode *

Country *

Telephone *

Please list a number that you can be reached at easily

E-mail Address *

Please list an e-mail address that you regularly check

Accommodation Required *

Yes

Please note that accommodation will be provided on SHARING BASIS ONLY

Previous flow cytometry experience (if any) *

Please limit your answer to a maximum of 500 words

Research Summary along with reason to attend flow training *

Please limit your answer to a maximum of 500 words

Approval of Research supervisor / Head of Institution *

Please upload recommendation letter with signature of supervisor (PDF document) Please note that incomplete forms will not be considered.
Files must be less than 800 KB.
Allowed file types: pdf.

Registration form for Training Program - 2017 / 2018

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