Application Format
Section A
1. Name of Applicant:
2. Postal address for correspondence:
3. Tel: Pin Code:
4. Email:
5. Address of the host Institution:
6. Date of Birth:
7. a Academic record (Graduation onwards)
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Degree |
Institution/ University |
Year of passing |
Major subjects |
Division (%) |
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b. Whether studying for any further degree.
If ‘Yes’ details regarding the same
c. Number of research paper published or
patents filed/granted (Give list only)
8. Attested copy of the last degree also needs
to be enclosed:
9. Whether passed any examination
conducted by NET, GATE, UGC, ICAR:
10. Professional/Employment Record if any:
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Designation |
Name & Address of Employee |
Period |
Emoluments |
Job description |
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From |
To |
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Section B
Brief details of the Laboratory/Technology Institution/S&T based voluntary organization that is proposing to host the project-
i) Name of organization:
ii) Contact person, designation, phone fax,
email (Specialization area)
iii) Information about the organization
regarding R & D experiences and list of
recent completed projects:
iv) Details of infrastructure to be provided
by the host organization:
Section C
i) Details of the field agency
ii) Name:
iii) Address:
iv) Contact person:
v) Area of operation:
vi) Area of expertise:
Section D
(Details about the project on which the applicant desires to work)
1. Title of the Project:
2. Duration:
3. Total cost:
4. Specific Objectives of the project (not
more than 2):
5. Technical Details:
i) Description of the problem
ii) State-of-the Art in the proposed area
iii) Interventions proposed/suggested
solutions and alternatives
iv) List of References
6. Methodology to be adopted
7. Detailed time schedule/major
milestones / bar chart (Quarterly/half
yearly / yearly)
8. Expected deliverables/outcomes
9. Proposed utility of the outcomes
10. Proposed Budget for two years: (Fellowship, Consumables, Travel, Equipment, Overhead Charges)
(Detailed justification for each item of the budget head needs to be provided)
Section E
Other documents need to be submitted along with the applications:
i) Forwarding letter from the host
organization
ii) Certificate from the host institute
regarding extending their commitment
for infrastructure and administrative
support for the project
iii) Certificate from the field agency
iv) In case the host is a voluntary
organization, attested copies of the
following document also need to be
submitted:
a) Registration certificate of the organization
b) Memorandum of association
c) Annual Report of last three years
d) Audited statement of accounts for last three years
Application
should clearly indicate the same of the scheme WOS-B
on the front page of the proposal. Five copies of proposal may be send
to Dr. Shobha Rao, Coordinator, WOS-B Scheme, Agharkar Research Institute, G. G. Agarkar
Road, Pune – 411 004.
(Incomplete applications will not be considered)
Declaration
I do hereby declare that the statements made in this application are true, complete and correct to the best of my knowledge and belief. In the event of any information being found false or incorrect or ineligibility detected before or after test/interview, my candidature will stand cancelled and my all claims for the scholarship will stand forfeited.
Place:
Date: Signature of Applicant