SERB-INDO-US POSTDOCTORAL FELLOWSHIP: 2015-16
APPLICATION FORMAT
(To be filled by applicant)
INSTRUCTIONS
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The application should be submitted in the prescribed format filled in Times Now
Roman, Regular, and Font size 12.
Application should not be more than 20 pages including CV, Research Proposal.
Candidates are encouraged to submit the application along with supporting documents as
a single MS Word/pdf document.
Applications in subject-fields other than those specified in the advertisement will not be
considered.
Please ensure to attach all the enclosures along with the complete application as per
the check-list at S.No. 28 on Page 5 of this document.
Completed application should be submitted electronically to the Indo-U.S. Science and
Technology Forum (IUSSTF) at fellowship@indousstf.org
APPLICATION FORMAT
1.
Name of Applicant:
2.
Designation:
3.
Department:
4.
Institute Name:
5.
Postal Address:
6.
Address for correspondence, if not employed:
7.
Date of Birth and Age:
8.
SC/ST/OBC/General:
9.
Telephone:
Sex (M/F):
Fax:
Mobile:
E-mail:
10. Employment [Do you hold a regular position in your institute? (Yes/No)]:
11. Academic qualifications:
Please provide details from degree level
Name of the
Name of the
Year of
Degree/Diploma
Institution
passing
Subjects taken
Div., % of marks
12. Details and nature of present and previous employment:
Please provide details of your work experience starting with the current Organization and going
back to previous organizations in reverse chronological order
Name and
Designation
Address of
and
Organization
Department
Duration
(from
mm/yy to
mm/yy)
2
Brief job description/Nature of work
13. Honours and awards received:
14. Specific area of research (from the list of areas indicated in the program
announcement):
15. Broad area of research:
 Atmospheric and Earth Sciences
 Life Sciences
 Medical Sciences
 Engineering Sciences
 Chemical Sciences
 Computational Sciences
 Mathematical Sciences
 Others (Please mention the area)
16. Host mentor in the United States:
17. Contact of host U.S. mentor (Postal address, Phone, E-mail):
18. Expertise of the host in the chosen area and significance of the host institute:
19. Proposed duration of the fellowship (in months):
20. Brief summary of your current areas of research:
21. Details of proposed research work (not more than 4 pages) which should include
Objectives, Work plan, how the proposed work will make an impact in the specified
area and the mutual scientific benefit to be accrued:
22. State any other relevant aspects in the application which may be useful for the
reviewer to make a qualitative judgment on the application:
23. Details of international fellowships availed:
S. No.
Address of overseas
Duration
institute
3
Agency
Brief
Achievement/
which
objective of
Outcome
sponsored
the work
the visit
done
24. Details of financial support sought from expected / committed sources other than
SERB/IUSSTF
25. Detailed CV of the applicant including:
 Name, Address, Date of Birth, Religion/Caste, Institute’s Address etc.
 Academic Qualifications (University /College from where attained, year of
passing, class, Thesis title etc.)
 Publications list (Title of paper, authors, Journal details, pages, year etc.)
 Patent list, if any
 List of Projects implemented
 Details of Research Projects being implemented/ completed/ submitted by
the Investigator including Name of the Institute
(Not more than 4 pages)
26. Brief CV of U.S host (Not more than 2 pages)
27. References:
Please furnish details of persons who can provide an assessment of your suitability for this
fellowship
Details
Reference 1
Name of Referee:
Designation:
Organization:
Email id:
Phone number:
Relationship with Applicant
4
Reference 2
28. Application checklist of documents to be submitted (Please mark ✓against the
document submitted):
 Completed application form
 Copy of the Provisional/ Completed PhD degree
 Brief CV of the Applicant
 Brief CV of the U.S host
 Letter of acceptance of research plan by the U.S host
 Two Recommendation Letters
 Statement from the employer (For permanently employed applicant)
 Filled-in Summary of the Applicant
Date:
Place:
Name and Signature of the applicant
(Name in Block Letters)
5
STATEMENT FROM THE CURRENT EMPLOYER
(FOR EMPLOYED APPLICANTS)
(This should be given on the official letter-head of the parent institution/organization in
the following format):
This is to certify that this institution has no objection for considering the application for
SERB-Indo-US Postdoctoral Fellowship from Mr./Ms./Dr………………………..
employee in the ……………(name of the department/institute/ organization) for
Postdoctoral
research
in
the area of……….………………to
be held
at……………………………..for the duration of……………months.
If the fellowship is awarded to him/her, Mr./Ms./Dr…………………will be relieved
from …………....(name of the institute/organization) duties for said period from the date
of his/her joining for research fellowship under SERB-Indo-US Postdoctoral Fellowship.
During this period, the continuity of employment on the post presently held by him/her
would continue to be applicable and rules governing payment of salary (basic pay and all
allowances), leave, medical benefits, gratuity, GPF, GIS, and pension etc. would continue
to be applicable during the entire period of fellowship and he/she will join his/her present
post on completion of tenure of his/her fellowship.
Date:
Place:
Name and Signature of Head of Institution
(Name in Block Letters)
Phone No.
E-mail:
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