QUALITY IMPROVEMENT PROGRAMME CENTRE
INDIAN INSTITUTE OF TECHNOLOGY ROORKEE
ROORKEE
PROFORMA FOR CD CELL ACTIVITIES
1.
Name of Faculty Member
(in Block Letters)
:
2.
Telephone No. :
3.
Mobile No.
:
4.
Email I.D.
:
5.
Department
:
6.
(i) Title of the work
:
(ii) Has the work been :
reviewed by an expert (s)
7.
Category Number as per
the letter
:
8.
(i) Originality of the work
:
______________ (R) ______________ (O)
Yes / No
(ii) Whether the Work is
proposal to be
:
done/ published for the
first time
9.
If it is a book written,
(certificate / letter of
publishing house to
be made available)
:
Enclosed / Not Enclosed
10. Details of the workshop / work :
(minimum in one page)
11. Approximate Expenditure
:
(please submit a separate sheet for the budget proposal under different heads like
travel, typing, stationary, remuneration, photocopy etc.)
Certified that the statements made above are true to the best of my knowledge. It is also
certified that this document / work is being sent for financial support for the first time.
Forwarded
(Head of Deptt.)
(Signature of Faculty Member)
Note : Following be enclosed –
1. Any documents in support of 8 (i) & (ii), and 6 (ii)
2. Full documents on which QIP financial support is sought.
3. If financial support is approved, it shall have to be acknowledged in the document.
4. In case the work done has not been published, then even QIP can decide to publish
also, with copyrights.