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Educational trip registration form
Fill-in the following form if you are interested in visiting NISER.
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* Indicates required question
A. Name of School/ College
*
Your answer
B. Address of School/ College
*
Your answer
C. Class of students
*
Your answer
D. Number of students
*
Your answer
E. Department to visit(select the ones you want to visit to)
*
School of Biological Sciences
School of Physical Sciences
School of Chemical Sciences
School of Mathematical Sciences
School of Earth and Planetary Sciences
All of the above
Required
F. Name of the Principal/ Head of Department
*
Your answer
G. Contact details of Principal/ HOD (Email ID, Mobile no.)
*
Your answer
H. Details of accompanying persons (Email ID, Mobile No., No. of teachers)
*
Your answer
I. Preference date of visit(only Fridays)
*
MM
/
DD
/
YYYY
Time of Arrival
*
Time
:
AM
PM
Time of Departure
*
Time
:
AM
PM
J. Remarks:
Your answer
K. For any other queries, please contact:
Dr. Debasmita P. Alone, Chairperson, Outreach Committee
Email ID:
outreach@niser.ac.in
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