DISTRICT LEVEL NATIONAL CHILDREN’S SCIENCE CONGRESS-2013

                                                         (PARTICIPANT REGISTRATION FORM)

  EDUCATIONAL DISRTICT................................             REVENUE DISTRICT...............................

  DATE....................................                                                                       VENUE..................................

            A.    PROJECT TITLE (CAPITAL LETTERS ........................................................................................................................

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       B.     NAME OF GROUP LEADER       SEX       STD        AGE       DATE OF BIRTH         SCHOOL ADDRESS                                                                                                                                                                               (CAPITAL LRTTERS)

            1.  .................................................        .........       ........        .......         .........................       .           .................................

            2..................................................         .........       ........        .......         .........................                   ..................................

            3. .................................................        .........       ........        .......         .........................                   ..................................

            4.  .................................................        .........       ........        .......         .........................                   ..................................

             5. .................................................        .........       ........        .......         .........................                   ..................................

         C.      WHETHER TWO COPIES OF PROJECT

              ABSTRACT SUBMITTED                                    :    YES/NO       D.      RURAL/URBAN

         E.               NAME AND ADDRESS OF TEACHER / GUIDE CAPITALETTERS).....................................................................

          F.                WHETHER OHP REQUIRED   : YES/NO

                         WHETHER SLIDE PROJECTOR REQUIRED    : YES/NO

          G.                LANGUAGE USED:          MALAYALAM / ENGLISH

               NAME OF GROUP LEADER: ........................................................SIGNATURE: .....................................

               NAME OF DISTRICT CO ORDINATOR: .................................  SIGNATURE: ....................................

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