LIFE SCIENCE INTERNATIONAL POSTGRADUATE EDUCATIONAL CENTER

UNESCO CHAIR IN LIFE SCIENCES
LIFE SCIENCE INTERNATIONAL POSTGRADUATE EDUCATIONAL CENTER

"Life Sciences International Postgraduate Educational Center would be developed as a regional education and research center serving to promote co-operation between scientists and to facilitate the exchange of information among researchers internationally".

Federico Mayor Ex-Director General of UNESCO

M.S. PhD

Name:

Lastname:

Date of birth:

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	-		-

Palce of birth:

Citizenship:

Nationality:

Marital status:

Married Single

Sex:

Male Female

Postal address

Phone:

Fax*

E-mail:

Knowledge of Language(English):

excellent good fair

List the degree you now hold or anticipate receiving and the school that has or will have awarded the degree :

Degree -Date Awarded - School:

Main specialization (List any awards, grants, scholarships, etc., you have received):

Proposed program of study:
	Biophysics
	Neuroscience
	Biotechnology
	Pain Study and Management
	Biomedical engineering

List any special programs attended, projects completed, teaching experience, publications, performance or exhibits, and/or any activities that would enable the review committee to better evaluate your application:

Please indicate if accommodation is required:

Yes No

Please attach any further information that could be relevant for your admission*.

* All fields are mandatory exept this two

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