The Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania Registration Form Short Course on Nuclear Physics and Materials 2015 Fill out the form, then scan/capture to send by email to [email protected]. First Name: ______________________ Last Name: _____________________________ Position: _______________________________________________________________ Organization: _______________________________________________________________ Address: _______________________________________________________________ Phone: ____________________________ E-mail: ________________________________ Note: This short course is offered at no cost to you as courtesy of NM-AIST. However, you are responsible for your travel arrangement, accommodation and meals. Accommodation and meals at affordable rate will be offered by NM-AIST. For more information, please contact the estate department ([email protected]). On-campus accommodation is limited. Therefore, it will be first come first serve base. For enquiry about the short course, please contact: Dr. Yusufu Jande ([email protected], +255655825866) This workshop is organized by the Department of Materials & Energy Science and Engineering and sponsored by the Nelson Mandela African Institution of Science and Technology, the University of Saskatchewan, Tanzania Atomic Energy Commission, and International Atomic Energy Agency.