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RASHTRASANT TUKADOJI MAHARAJ NAGPUR UNIVERITY
Application form for grant of financial assistance from Teacher Welfare Fund on
account of travel expenses for attending International conference /Seminars/
Congress/Symposia abroad to members of teaching staff in the universities, affiliated
& conducted college of university.
1. Name of the Teacher beginning with surname :
2. Name of the College/University
:
3. Designation
:
4. University approved letter no. & date
(Copy enclosed)
5. Date of Birth
:
6. Permanent Address & Contact No.
:
7. Academic Qualification (with division secured) :
8. Teaching Experience (Number of years)
:
9. Record of Employment
:
10. Details of significant Publication
:
11. Details of the Travel abroad in the past
:
Country
Year
Duration
Purpose of Visit
12. Have you availed financial assistance to :
Attend international conference/ seminars
From UGC or other funding agencies in the
Last 3 years
13. If yes, when & where
:
14. Details of the International Conference etc,
You desire to attend
i)
Venue
:
ii)
Duration
:
iii) Organizing agency :
15. Whether you have submitted a paper
to the conference
:
Funding Agency
16. Whether your paper has been
Accepted by the organizer
17. If so, submit copy of email
communication soft & hard
:
:
18. Enclose copy of the full paper/Abstract :
19. Whether you are invited by the organizer
to present your paper
20. Is so, enclose 1 copy of the email
Communication from the organism
:
21. Details of the facilities offered by the
Sponsors organism of the conference
:
Item
A)
B)
C)
D)
TA
Lodging
Boarding
Any other
:
22. Details of To & Fro travel expenditure
to be incurred in Indian currency :
:
23. Financial assistance expected from
:
Sources other than State Government
Like Govt. of India, UGC, University College
His/Her own contribution
24. Any other information you desire to
Furnish
:
25. Recommendation of the Head/Principal :
Place :
Date :
Signature
Designation
Head of the Department/Principal
Place :
Date :
Signature
Designation
Head of the Department/Principal
Place :
Date :
TRAVEL GRANT PROCEDURE FOR APPLYING UNDER MERGED SCHEME (UGC
UNASSIGNED GRANT) ALL DOCUMENTS TO BE SUBMITTED IN TWO COPIES
FIRST ORIGINAL & SECOND TRUE COPY FORWARDED AND
ATTESTED BY H.O.D. ALONGWITH COVERING LETTER
1.
Covering letter forwarded by H.O.D/Principal.
2.
Application form to be filled in duplicate.
3.
Invitation letter alongwith broacher/Literature.
4.
Letter from organizers regarding sponsorship if any.
5.
One copy of presentation of paper.
6.
Paper presentation acceptance letter from organizers.
7.
Statement of estimated expenditure.
8.
Permission letter from Institute.
9.
Travel is on Air India to the nearest point of destination and passenger must
hold on Air India Ticket (Travel fare corticated only from Air India)
10. All documents attested by H.O.D/Principal or self attested.
11. The work and the detailed plan of such visits, should be submitted alongwith
the proposal to the university.
12. Visa expenditure for the first time visit to abroad.
PROCEDURE OF ACCOUNT SUBMITTING AFTER ATTENDING CONFERENCE
ALL DOCUMENTS TO BE SUBMITTED IN TWO COPIES, FIRST ORIGINAL
& SECOND TRUE COPY FORWARDED AND ATTESTED
BY H.O.D. ALONGWITH COVERING LETTER
1.
Covering letter forwarded by H.O.D.
2.
Participation Certificate (Attendance Certificate)
3.
Actual statement of expenditure
4.
T. A. Bill certified by Audit Section (First Mark Paid & cancelled and after self
attested)
5.
Original Air Tickets & Railway Tickets (First Mark Paid & cancelled and after
self attested)
6.
Original Receipt of Registration fee (First Mark Paid & cancelled and after self
attested)
7.
List of foreign currency convert to Indian currency.
8.
All documents attested by H.O.D or self attested
9.
All bills & tickets first mark paid & cancelled and after self attested
10. Cash Voucher.
11. Report of the programme.
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1
RASHTRASANT TUKADOJI MAHARAJ NAGPUR UNIVERSITY
TEACHER WELFARE FUND COMMITTEE
APPLICATION FOR A) BEST TEACHER AWARD, B) BEST SCIENTIST/RESEARCHER AWARD
C) BEST WRITER AWARD, D) BEST TEACHER INVOLVED IN SOCIAL ACTIVITIES.
(Separate application have to be submitted for each category in seven copies)
Passport
size photo
1.
General Information
(a)
Name
(b)
Address
i)
Residential
: ……………………..………...……………………………
: ……………………………………….……………………
…………………………………….………………………
……………………………………..………………………
ii)
Contact Number
: Ph. No. ……………………… Mob. No. …………………
Email ………………………………………………………
iii)
College/Institution
: ………………………….………….………………………
…………………………….…….…………………………
……………………………………..………………………
c)
Designation
: ………………………………………..……………………
d)
Department
: ……………………………………..………………………
……………………………………………..………………
e)
Date of Birth
: ……………………………………………..………………
f)
Name of Faculty
: ……………………………………..……...………………
g)
i)
h)
2.
Date of appointment as
: ………………………………………….…………………
Teacher
ii) Total experience as a
: ……………………………………………..………………
teacher
Date & Reference no. of the : ……………………………………………..………………
letter from the University
……………………………………………..………………
approving the Appointment as
……………………………………………..………………
Teacher.
Academic Qualification :
Examination
Year of
Passing
Name of
Board/
University
Division
% of Marks
obtained
Subjects offered
(Specialization, if
any)
2
3.
Details of Ph.D/NET/SET /M.Phil/D. Litt./D.Sc. Degree
Degree
4.
Subject
Year
University/UGC/etc.
Teaching Experience pertaining to the period.
Designation
Period
Experience
From
Total Experience
To
Under Graduate
Post Graduate
Research Guidance
5.
: ……………………………………………......…………
Research Experience (Give brief
outline of research areas)
6.
7.
…………………………………………….…..…………
Research Project (Major/Minor) carried out, if any.
Sr.
Major/Minor
Title of Project
Name of the
No.
Funding agency
Amount
sanctioned
Ongoing/
Completed
(a)
Are you a recognized Ph.D. : ……………………..………...……………………………
Supervisor/guide? (mention
……………………..………...……………………………
date and reference letter from
……………………..………...……………………………
the University)
(b)
Number of students working : ……………………..………...……………………………
with you at present ?
……………………..………...……………………………
(c)
Number of students awarded :
Ph.D. under your guidance.
Name of the Student
Topic of Research
Date of Registration
8.
Give details regarding Research papers published in peer reviewed Journals, Book
published with ISSN/ISBN.
Sr.
Name of the
Author
Edited
Publisher
Year of
ISSN/ISBN
No.
Book/Journal
Publication
No.
9.
Details regarding Patents/Copyrights if any.
Sr. No.
Details of Patents/Copyright
Year of award
Agency/Body
3
10. Honour/Awards/Prizes received
: ……………………………………………..………………
……………………………………………..………………
……………………………………………..………………
11. Do you have experience in
following?
(a) As the National level such as : ……………………..………...……………………………
NAAC, AICTE, NCTE
……………………..………...……………………………
(b) At
the
State
Level : ……………………..………...……………………………
Committees
formed
by
……………………..………...……………………………
Government of Maharashtra
(c) At the University level : ……………………..………...……………………………
(Board of Studies/Academic
……………………..………...……………………………
Council/Senate/
Management Council)
12.
Presentation of research paper in various National & International Seminar,
Conferences, Symposia, Workshops etc. and its Publication in conference proceedings,
edited volumes etc.
Sr.
Name of
Conference
Title of paper
Details of
ISSN/ISBN
No.
Conference with
Attended
publications
No.
date
international
/national/state
13.
Invited as guest Speaker, Chairperson, Rapoteur
Conferences, Symposia, Workshops.
Name & Date
Conference
Title of paper
Attended
international
/national/state
14.
at National/International, Seminar,
Delivered
keynote
address
Chaired a
Session.
Details of Conferences, Symposia, Workshops etc. organized
i)
by you as Principal Organizer
ii)
In your college.
State/National Title Duration
No. of Participants
/International
State
National
International
Conferences
Sympsia
Workshops
Guest
Speaker
Total
Expenditure
4
15.
Involvement in Innovative/ Community Service/Student development through NSS,
NCC programmes (in detail). Interaction with Industry Other Colleges/ Institutes,
NGO’s etc.
(a)
(b)
(c)
Extension Work/Community : ……………………..………...……………………………
Service
Efforts to bring communal/ : ……………………..………...……………………………
harmony, Addressing issues
of diversity
Environmental
problems, : ……………………..………...……………………………
Water Harvesting, Green,
Clean, Campus.
16.
Details of being acknowledged expert in subject/field/as an educationist/as Scientist.
Sr. No.
Area of specialization
Authority
Year
17.
Details of Paper Setter/ Examiner/ Moderator/ Chairman/ Exam.Co-ordinator at
University level.
Sr. No.
Particulars
Year
University
18.
Details of Participation in University authorities and various bodies of the University.
Sr. No.
University body
Year
University
19.
Details of imparting soft skills/ communication skills/ personality development courses/
modules etc.:Sr. No.
Particular
Year
University
20.
Details of Organizing & conducting popularization programmers/ teaching – learning
Evaluation teaching programs training courses in computer assisted teaching/ webbased learning & e-library skills to students.
Sr. No.
Name of Activity
Dates
University
21.
Details of Participation in NCC/NSS/Cultural Activities/Sports/Extra Curricular
Activities/Extension Activities.
Sr. No.
Activity
Year
5
22.
Participation in the Various Scientific committees /Bodies of the State / Central
Government & its Organization.
Sr. No.
Activity
State/National/International
Year
23.
Details of consultancy services provided.
Sr. No.
Activity
State/National/International
24.
Year
Details of Articles/Chapters/Papers published in Books.
Sr. No.
Title of Paper/Chapter
Publisher
ISSN/ISBN No.
Year
25.
Details of articles in regional/national/ international newspaper and periodicals.
Sr. No.
Title of Article
Publisher with place
Date/ Year
26.
Details of reference book published in the subject.
Sr. No.
Title of Book
Subject
Publisher
ISBN No.
Year
27.
Details of being Editor, editorial advisor etc.of reputed journal /Chairman/Member of
editorial board of reputed books/ journals.
Sr. No.
Name of Journal
Position held
Place of
ISSN No.
Publication
28.
Recipient of various Awards as a best author by State/Central Government & other
recognized bodies.
Sr. No.
Name of Award
Authority
Year of award Place of Award
29.
Recipient of various Awards as a best author in respect of the articles published in the
various Journals/Newspapers/ periodicals etc. by State/Central Government & other
recognized bodies.
Sr. No.
Name of Award
Publisher
Date/ Year
6
30.
Published books in the literature of various languages.
Sr. No.
Title of Book
Subject
Publisher
ISBN No.
Year
31.
Experience in implementation of the various schemes of the State/Central Govt. & its
Organization in respect of Community development/ Social Welfare.
Sr. No.
Name of Scheme
Authority
Area of work
Year
32.
Participation in implementation of the various schemes of the UGC & various
department
of
the
State/Central
Govt.
for
ufliftment
of
SC/ST/OBC/Minorities/Women/Poor and other socially and economically backwards
community.
Sr. No.
Name of Scheme
Authority
Activity
Year
33.
Participation in Adult & Continuing Education/ Extension Services/Community
development etc.
Sr. No.
Name of Activity
Year
34.
Office Bearer of reputed social organizations/charitable trust which are actively
involved in the Social Welfare activities.
Duration
Sr.
Name of
Whether
If Yes, no.
Post
Details
No.
Organization/
registered
of
held From
of
To
Charitable Trust
YES/NO registration
activity
35.
Details of participation in social/public movement of state/national level.
Sr. No.
Name of
Your role
Local/State/National
Activity/movement
36.
Year
Details of awards received as social worker by state/Central Government & other
recognized bodies.
Sr. No.
Name of Award
Authority
Year
Venue
7
37.
38.
Contribution to Corporate Life and Management of the Institution/University/
Professional Development Activities.
Sr. No.
Name of Activity
Authority
Year
Participation in Corporate life:
: ……………………..………...……………………………
a)
College/University/Institution
: ……………………..………...……………………………
b)
Co-curricular activities
: ……………………..………...……………………………
c)
Enrichment of Campus Life : ……………………..………...……………………………
(Hostels,
sports,
game,
cultural activities)
Students Discipline
: ……………………..………...……………………………
d)
e)
f)
g)
39.
Professional Organizations of : ……………………..………...……………………………
Teachers
National Literacy Mission
: ……………………..………...……………………………
Please give a short account of : ……………………..………...……………………………
your contribution to –
Community work such as
values of National integration,
secularism,
democracy,
socialism. Humanism, peace,
scientific temper, flood or
drought relief, small family
norms etc.
Any other information the : ……………………..………...…………………….………
applicant would like to furnish
……………………..………...…………………….………
……………………..………...…………………….………
Note:- i)
ii)
Attach a separate sheet if required in Column as an annexure .
Attach photo copies of relevant documents wherever necessary.
Signature of the Teacher.
Recommendation of the Principal/Head
I recommend Dr./Shri./Mr/Mrs./Miss. …………………………………………………………………
of Department/College…………………………………………………………………. for the award.
Signature with Seal of
Principal/Head