Registration Form (ពាក្យសុំចុះឈ្មោះ)

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

This form allows you to register for the monthly seminar entitled "Primordial Black Hole formation and Gravitational Wave production in the Horndeski theory of gravity". Please input all the required information below. (ពាក្យសុំចុះឈ្មោះនេះអនុញ្ញាតអោយអ្នកចុះឈ្មោះចូលរួមក្នុងកម្មវិធី seminar ប្រចាំខែ ស្តីអំពី "Primordial Black Hole formation and Gravitational Wave production in the Horndeski theory of gravity" ដែលនឹងរៀបចំដោយសាលាក្រោយបរិញ្ញាបត្រផ្នែកវិទ្យាសាស្ត្រ នៃសាកលវិទ្យាល័យភូមិន្ទភ្នំពេញ។ សូមបំពេញរាល់ពត៌មានចាំបាច់ខាងក្រោមដើម្បីចុះឈ្មោះ!)

Email *

Please input your name! (សូមបញ្ចូលឈ្មោះរបស់អ្នក!) *

Select your gender! (ជ្រើសរើសភេទ!) *

Male

Female

Input your affiliation! (សូមបញ្ចូលឈ្មោះស្ថាប័នការងាររបស់អ្នក!) *

Royal University of Phnom Penh (RUPP)

Other:

Select your position/Occupation? (សូមជ្រើសរើសតួនាទី/មុខរបររបស់អ្នក!) *

Researcher

PhD Student

M. Eng./M. Sc./M. A student

B. Eng./B. Sc./B. A student

Other:

Give your phone number! (សូមផ្តល់ទូរស័ព្ទទាក់ទង!) *

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms