Nothing Special   »   [go: up one dir, main page]

Application Form SFRF-2020 PDF

Download as pdf or txt
Download as pdf or txt
You are on page 1of 2

Indian Institute of Technology Delhi

Continuing Education Programme


Hauz Khas, New Delhi - 110 016
Tel: +91-11-26597118/ 26591915
Web: http://cepqip.iitd.ac.in

Application Form Summer Faculty Research Fellow Programme - 2020

Name: ______________________________________________________________________

Designation: _________________________________________________________________
Department: _________________________________________________________________ Please affix a
recent passport
Institution/College with Address: _________________________________________________ size
___________________________________________________Pin Code: _________________ photograph

Address for Correspondence: ____________________________________________________


____________________________________________________________________Pin Code: _________________
Mobile No.:_______________________________ Email: ______________________________________________
Date of Birth: __________________________ Gender: (Male/Female) ________________

Qualification (in reverse chronological order)*

Degree Branch Year of College/University Institution % of marks


Specialization passing obtained

Total Experience (in reverse chronological order)*

Name & Address of Employer & Duration Designation


Institution
From To Years-Months

* (Please feel free to attach a separate sheet in case of insufficient space)


Have you attended any SFRF programme in the past? (Yes/No) ________________________________________

If yes give details ______________________________________________________________________________

Any other Information: _________________________________________________________________________

Area of Interest: ______________________________________________________________________________

____________________________________________________________________________________________

Name of the Faculty Mentor from 1)


IIT Delhi 2)
In order of preference from the list
displayed on the website: 3)
http://cepqip.iitd.ac.in/mentors.php 4)

Accommodation required? Yes/No ____________________

Declaration:

I_______________________ declare that all the information given by me in the application form is correct.

Place:__________________
Date:__________________ Signature of Applicant

No Objection Certificate

Ms./Mr.__________________________________ working as______________________________ in the


department/centre of _________________________________ at________________________________
_____________________________________________________________________________ is hereby
permitted to attend the Summer Faculty Research Fellow Programme - 2020 (SFRF-2020).
This Institute/College has no objection for attending full time research work by above faculty at IIT Delhi
under Summer Programme from ____________________ to _______________________.

Signature & Seal of Head of the Institution/College

(Please forward this application form (duly filled and signed/authorized by competent authority) to,
The Head QIP/CEP/TEQIP-III, QIP-CEP Office, 1st floor, Wing-B, Vishwakarma Bhawan, Indian Institute of
Technology Delhi, Hauz Khas, New Delhi – 110 016 latest by March 31, 2020 (Tuesday)

You might also like