iThemba LABS Nuclear Physics Vacation Programme
Application Form
Instructions
1. Please complete this form and fax or email it to the iThemba LABS physics
group coordinator ( contact details listed below) together with your :
 CV
 Transcript of academic record
2. Please inform the referees you select that their letters of recommendation
must reach iThemba LABS coordinator on or before 5 November 2012
3. Contact details:
Ntombizonke Kheswa
e-mai: Kheswa@tlabs.ac.za
tel (w): (021) 843 1122
fax: (021) 843 3525
First Name(s):
Surname:
Date of birth:
Gender:
Home address:
Telephone (home):
Term address (fill in if you don’t stay at home while you are studying)
Telephone no. during term:
Mobile no.:
e-mail address:
University where you are registered:
Degree you are registered for:
Year of study at university:
Subjects you are currently registered for:
List the Physics courses that you will complete this year:
Which Physics course did you find most interesting?
In which of the iThemba LABS research areas in Nuclear Physics would you
like to do a project?
Nuclear structure/reaction mechanism/environmental research/not sure
Explain how you think you can benefit from the internship programme.
What would you like to do after completing the degree you are currently
registered for?
Please give details about your computer and programming skills.
Please provide us with the names of at least one (if possible two) referee(s).
They must have lectured you in the past year, at least one must be from the Physics
department.
Referee 1
First Name (s):
Surname:
Title:
University:
Department:
e-mail address:
Courses lectured and when:
Referee 2
First Name (s):
Surname:
Title:
University:
Department:
e-mail address:
courses lectured and when?
Did you work at iThemba LABS before? Yes/No
If Yes, when and under whose supervision.
For what period do you intend to join the vacation programme?
(at least one month for the June holiday and two months for the December holiday)
Please fill in the exact dates.
From:
To:
If your application is success would you need accommodation to be arranged
for you during your vacation job? Yes/No
How did you find out about this vacation programme?
Friend/ poster/internet/lecture/other