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ICMR-CNMC Award Application Format

1. The document provides an application format for the ICMR-CNMC STS Excellence Award. 2. Applicants must fill out the application in the specified format as a single PDF file and email it by the declared deadline. 3. The application requests information such as the applicant's personal details, educational qualifications, employment history, STS program details, publication details, research work details, and a declaration signed by the candidate.

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245 views3 pages

ICMR-CNMC Award Application Format

1. The document provides an application format for the ICMR-CNMC STS Excellence Award. 2. Applicants must fill out the application in the specified format as a single PDF file and email it by the declared deadline. 3. The application requests information such as the applicant's personal details, educational qualifications, employment history, STS program details, publication details, research work details, and a declaration signed by the candidate.

Uploaded by

goutham valapala
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Division of HRD

APPLICATION FORMAT
“ICMR-CNMC STS EXCELLENCE AWARD”

Hard copies will not be accepted.


Recent
I. Type the information in the given format. coloured
Hand written form will be rejected. Passport Size
II. Single PDF file format of the application, reprint of the Photograph
Publication & CV to be sent by email to [email protected]
III. Last date to submit application is (to be declared........)

Title of the STS research work submitted for the

award.........................................................

..............................................................................................................................................

...

1.
a) Name :
b) Designation/Present position :
c) Present Institutional affiliation :
2.
a) Mobile telephone :
b) Landline telephone :
c) Fax number :
d) E-mail ID :
e) Address for correspondence :
3.
a) Date of birth :
b) Age :
c) Sex :
4.
a) Year of participation in STS program :
b) STS reference ID :
c) STS research topic :
5.
a) Name and address of the Medical/Dental :
College from where the candidate
participated in STS Programme
b) Name and Designation of the Guide :

6. Educational qualifications of the candidate from 10th Class onwards:


Course/Qualifications Board/University/Institute Year of passing

7. Employment details (if applicable)


Position Organisation From To

8. Details of publication based on research


carried out under STS 2018/2019/2020
a) Title of the Paper :
b) Name of the Journal and issue number :

(Enclose reprint of the paper)


9. Subject of research work presented :
for the award.
Give a brief write up highlighting the
Scientific contribution and its importance
10. Details of any other publications (if any) :

of the applicant
11. Whether you have received any award or :
presented the paper in any national/
international conference, if so, give
details
a) Name of the award :

b) National/International Conference :

(Year and Detail)


c) International Conference :
(Year and Details:
12. If you are joint author, state precisely :

what has been your individual


contribution to the STS work published
13. Give name, designation and work done :
by all the joint authors, if yes.

DECLARATION

I hereby declare that the entries in this form and the additional particulars, if any,
furnished herewith are true to the best of my knowledge and belief.
Place:
Date: Signature of Candidate

Important Note:-
1. Application received after the closing date for whatever reason is liable to be rejected.
2. If the fact that false information has been furnished or that there has been suppression of any
material information in the application form by the applicant comes to our notice, then his/her
application is liable to be rejected.
3. Application not signed by the candidate is liable to be, rejected.
4. Incomplete and handwritten applications will be rejected.

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