Designed Developed and Maintained by
Annexure-II
Instructions:
1. Application form should be filled out by the applicant in typewritten English
2. Letter of Consent issued by Indian host Institution is an indispensable attachment for this application form.
| Personal Information | |||
|---|---|---|---|
| Applicant Name (Given Name/ Surname) | |||
| Nationality | |||
| Gender | |||
| Date of birth(dd/mm/yyyy) | |||
| Current Position held | |||
| Present Affiliation/ organization | |||
| Contact Information | |||
| Telephone/ Mobile Number | |||
| Email Address | |||
| Contact Address | |||
| Indian host Institution | |||
| Name of Organization/ Institute | |||
| Contact person (full Name, address, Institute and contact details, emails etc) | |||
| Education Background (from board/ university) | |||
| Name of Board/ University/ Institution | Academic degree | Major Subjects | Period |
| Work/ Research Experience and a list of latest publications (Not more than five) | |||
| Name of organization | Position | Period | |
| Research Proposal with Objectives, Scope of Work, Methodology and Deliverables. | |||
| (please state the research experience related to the proposed topic of scientific research in India, not more than 500 words) | |||
| Research Plan in India | |||
| (please state the research plan to be carried out in India (not more than 500 words) | |||
ENDORSEMENT OF PRESENT EMPLOYER
The application of Dr./Mr./Mrs./Ms.---------------- whose signature is given
below, is recommended for consideration for the ASEAN-India Research Training Fellowship
(AI-RTF) in India. If selected, Dr./Mr./Mrs./Ms.--------------------....................... will be
sanctioned leave for the Fellowship period of six months and will join his/her duties back in
this Organisation on completion of the Fellowship period in India.
Signature of Applicant :
Name of the recommending officer (in full)
Designation:
Signature of Recommending Officer :
Place:
Date: Seal: