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Page 1: Short Term Training Course - mdurohtak.ac.in
Page 2: Short Term Training Course - mdurohtak.ac.in

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]


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