Application Format

Section A

1.  Name of Applicant:

2.  Postal address for correspondence:

3.  Tel:                          Pin Code:

4.  Email:                      Mobile:

5.  Address of the host Institution:

6.  Date of Birth:

7. a Academic record (Graduation onwards)

Degree

Institution/ University

Year of passing

Major subjects

Division (%)

 

 

 

 

 

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:

Designation

 

Name &

Address of        Employee

Period

Emoluments

Job description

 

 

From

To

 

 

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