PRE-REGISTRATION

Family Name:

First Name:

Civility:
Mme
M.

Birth date:

Birth place:

Nationality:

Personnal address:

City:

Postal code

Country

E-mail:

Mobile Phone:

Please outline in a few words (5000 characters max) why you wish to study in this master, by mentioning if you are rather interested in the physics or the mathematical aspects of the program study. Do not hesitate to provide any additional information about yourself (interests, lab experience, etc.) that may support your application. Your statement of purpose can be written either in French or in English.

Please describe your current studies and the previous studies followed during the last 4 years (starting with the most recent). For each year, please mention the institution, the degree program, the field of study, the date of completion and your ranking.