| To apply:
Fill in and submit this form to a.stremoukhova@innopraktika.ru
Deadline
Both the completed form and the letter of reference should reach us not later than January 28, 2015.
Fields marked with "*" must be filled in.
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| Personal
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| Family Name
| *
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| First Name
| *
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| Your e-mail address (one only)
| *
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| Nationality
| *
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| Sex
| Male Female
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| Date of birth
| (DD MM YYYY)
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| Home Institute
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| Name of your Home Institute, location
| *
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| Faculty
| *
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| Chair where the thesis research will be carried out
| *
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| Present stage of study
| - 4th year student
- 5th year student
- 6th year student
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| When do you expect to obtain your diploma (year)?
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| Title of the previous term paper and grade for it
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| Reference
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| Name of supervisor/professor
| *
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| Email address of suprevisor/professor
| *
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| Telephone number of supervisor/professor
| *
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| Date of letter of reference
| (DD MM YYYY)
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| Knowledge of English
|
| Reading
| Advanced Upper-Intermediate Intermediate Pre-Intermediate
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| Writing
| Advanced Upper-Intermediate Intermediate Pre-Intermediate
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| Speaking:
| Advanced Upper-Intermediate Intermediate Pre-Intermediate
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| Past work at CERN
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| Have you ever worked at CERN?
| -- Yes No
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| If YES then, when?
| From (DD MM YYYY) to (DD MM YYYY)
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| In which Division?
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| Previous Applications
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| Have you applied to attend any of the previous schools organized by CERN and/or JINR and/or CNIR?
| -- Yes No
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| If so, which (name, year)?
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| Was your application accepted?
| -- Yes No
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| How did you hear about the School?
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| Brief description of your work
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| Provide a 100-word description (in English) of your current work. A sample description is provided below:
Example: For my thesis I am working on DELPHI, one of the four universal detectors operating at LEP e+e- collider at CERN. I have performed analysis of the data collected by DELPHI at the energies of LEP near the Z-resonance. In this analysis the measurement of the tau-lepton polarisation through its hadronic decay modes has been performed providing a competitive measurement of the weak mixing angle. Now I am working on the analysis of the high energy LEP data, measuring the fermion-pair production cross sections and forward-backward asymmetries. From the hardware side I am engaged with the work of monitoring the performance of the DELPHI Hadron Calorimeter and Surround Muon Chambers. This includes development of the monitoring software and data analysis.
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| Other Comments
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| Please indicate why you are applying,and also add other information that does not fit elsewhere in this form:
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| Before submitting, please remember that...
• The letter should reach the appropriate address specified at the top of this page by 28 January, 2015.
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