Small Satellite Engineering and Design for Oic Countries

ISNET/TUBITAK UZAY WORKSHOP ON

SMALL SATELLITE ENGINEERING AND DESIGN FOR OIC COUNTRIES

20-24 OCTOBER 2014

ANKARA, TURKEY

Application Form

1. Title: Prof. Dr. Mr. Mrs. Ms.

2. First Name Middle Name Surname

[Type text] [Type text] [Type text]

3. Gender [Type text]

4. Nationality [Type text]

5. Position / Designation [Type text]

6. Organisation [Type text]

7. Highest qualification [Type text]

8. Field of specialisation [Type text]

9. Title of paper [Type text]

10. Abstract attached: Yes No

11. Do you wish to participate in the hands-on training part of the Workshop? Yes No

12. Give details of your experience related to small satellite engineering and design

[Type text]

13. List your relevant published research papers

a. [Type text]

b. [Type text]

c. [Type text]

14. Telephone (country/area code separated by a dash (-)) [Type text]

Cell (mandatory field) [Type text]

Fax [Type text]

Email (mandatory field) [Type text]

15. Postal address [Type text]

16. Passport No [Type text] Date & Place of Issue [Type text] Date of expiry [Type text]

17. English Language Proficiency

Note: This application form should be electronically filled in and submitted at latest by 30 July 2014 alongwith a scanned copy of recommendation letter issued from the head of your organisation and valid travel passport.