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LINDAU NOBEL LAUREATE MEETINGS PROGRAM

Pakistan Institute of Engineering and Applied Sciences (PIEAS)
45650 – Nilore, Islamabad, PAKISTAN

APPLICATION FORM
for participation in:

 69th Lindau Nobel Laureate Meeting

dedicated to the field of Physics
DEADLINE: Sunday 26 August 2018, 3 pm PKST

Please note that:

FOR OFFICE USE ONLY
 Before applying, review the application guidelines
and eligibility criteria at: www.pieas.edu.pk/nobel
 App No ____________________
 Applications will not be accepted for people who are:
1. older than 35 years at the time of application,  Category ___________________
2. have participated in a previous Lindau NL meeting.  Original Form Received _______
 Preference will be given to applicants:
 Data Complete ______________
1. with strong commitment to their principal field of studies
and to interdisciplinary collaborative work,  Processed __________________
2. who have top positions in board or university examinations,  Eligible ____________________
3. who have published their research, and
4. who do not hold permanent faculty positions.  Comments _________________
 Short-listed applicants will have to appear in person for interviews in Islamabad.  This form superseded ________

Guidelines to fill, save and print the form

 Only the grey shaded fields are editable.

Fields can be selected by click of your mouse, or arrow buttons on your keyboard.
 Insert your recent coloured photograph by clicking the button ( ) in the centre of “Photograph” field.
 For filling any field select it and type-in your information. You may also use the arrow keys, or the “Tab” key, on your
keyboard to move from one field to another.
 Where dates are asked, please type dates as per format dd-mm-yyyy (for example, 31-12-2001).
 After filling all fields in the form, save the file using your name replacing blanks with underscores as the file-name, for
example “FirstName_MiddleName_LastName.docx”. Email the saved file to PakLindau@pieas.edu.pk.
 Simply print using A4 paper size. Sign the form, and send the signed hardcopy to:
Director, Nobel Laureate Meetings Programme,
PIEAS, 45650 – Nilore, Islamabad

1. APPLICANT DETAILS
Name (exactly as in passport) Photograph
Title First Name Middle Name Last Name

Father’s Name
Date of Birth Age
Place of Birth Gender Female
Nationality
Are you studying/working in Pakistan?
CNIC Number
CNIC Issue Date CNIC Expiry Date
Passport Number
Passport Issue Date Passport Expiry Date

69TH LINDAU NOBEL LAUREATE MEETING | Application Form Designed and developed by Dr. Kamran Safdar, Head PRD, PIEAS. 1/3
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Telephone Numbers:
Residence (along with area code)
Office (along with area code)
Fax (along with area code)
Cell Phone(s)
Email Address
Residential Address
Residential City
Permanent Address
Area of Research / Field of study (five words or less)

2. AFFILIATION / RESEARCH OFFICE

Institute Name
Your Reference / Name Research project position
Contact Person
Full Postal Address
Email
Office Telephone Fax Cell phone

3. EMPLOYMENT/RESEARCH STATUS
Please select one:
Applicant is enrolled in a degree program at a Pakistani Applicant has undertaken a degree program and the
University. applicant’s most recent degree has been conferred.

Present status:
Student Researcher Teacher Other, please specify:
Institution
Degree title
Thesis title
Date of commencement Date of completion
Project position held
Number of research publications through-out the career:
International journals National journals
International conferences National conferences
Books Book chapters
Total impact factor Total citations

4. ACADEMIC CAREER
%age Position, if any, in
Exam Institution Year marks Subject(s) Board/University
SSC / O’Level
FSc / A’Level
BSc (2-yr)
MSc / BS (4-yr)
MPhil / MS
PhD
Any other

69TH LINDAU NOBEL LAUREATE MEETING | Application Form Designed and developed by Dr. Kamran Safdar, Head PRD, PIEAS. 2/3
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5. PLEASE ANSWER THE QUESTIONS BELOW IN THE BOXES PROVIDED.
NOTE: You may use 1000 characters (including spaces) at the most per answer.

1. What is the motivation behind your studies and/or research? What is your distinction?

2. How fruitful will be your participation in the 69th Lindau Nobel Laureate Meeting, for your personal career,
and for the country? What makes you the most suitable candidate for selection for the meeting?

3. Please use the box below to provide any additional information relevant to your application.

6. ATTACHMENTS
Please attach the following documents:

1. Curriculum vitae (maximum two pages).

2. Recent publication list, including conference presentations (maximum two pages).

NOTE: Short-listed candidates will be required to bring along their original documents and two letters of recommendation at
the time of interview. Strong letters of support from your academic advisors or internationally renowned scientists
highlighting your academic achievements, research excellence, tutoring experience, awards & distinctions, and any other
items specific to your application will greatly help.

7. CERTIFICATE
By submitting this application, the applicant agrees to all terms and conditions of the NL Meetings programme including, but not
limited to, the following:

1. The applicant certifies that all information provided by him/her is correct to the best of his/her knowledge.
2. PIEAS and the selection board reserve the right to reject any application without mentioning any reason.
3. The applicant will be available to take up the opportunity if successful. All delegates are expected to attend the full
program of events issued by PIEAS and the Lindau Council.

Signature of applicant:

Name:
Date: Monday, 15 April 2019
Place:
This form was last saved by Dr. Kamran Safdar on Tuesday, 24 July 2018 3:45 PM, and
was last printed by Dr. Kamran Safdar on Monday, 15 April 2019 5:48 PM.

Submit your application form and all supporting documents to PakLindau@pieas.edu.pk.

Also send a signed hard-copy to:

DIRECTOR, LINDAU NOBEL LAUREATE MEETINGS PROGRAM

PAKISTAN INSTITUTE OF ENGINEERING AND APPLIED SCIENCES (PIEAS)
45650 – NILORE, ISLAMABAD

69TH LINDAU NOBEL LAUREATE MEETING | Application Form Designed and developed by Dr. Kamran Safdar, Head PRD, PIEAS. 3/3