Embassy of India, Kathmandu invites applications on prescribed ICCR’s form/ data-sheet from Nepalese nationals desirous of seeking admission to Undergraduate/ Post Graduate courses in
Ayurveda/Unani/Homeopathy system of medicines in Indian institutions for the academic year
2013-14.
2. Eligibility Criteria:
Undergraduate Courses: Candidates must have passed Class-XII or equivalent examination with
Physics, Chemistry, Biology and English as subjects and should have secured a minimum of 50% marks in English in class XII . The candidate should be between 17 and 22 years of age as on July
01, 2013.
Postgraduate Courses: Candidates must have passed graduation level examination in the concerned system of medicine with a minimum of 50% marks in English in Class-XII examination. The candidate should be 30 years or less as on July 01, 2013.
3. Selection Process:
(i) The short-listed candidates will be informed individually for interview, which will be conducted in Kathmandu / Birgunj / Biratnagar. They are advised to interact solely with the
Education Wing, Embassy of India, Kathmandu or Consulate General of India, Birgunj or Embassy of India, Camp Office, Biratnagar about the scholarship. The candidates should indicate their address and contact telephone numbers / e-mail address clearly in the prescribed column of the application form. Any change in address / telephone number should also be intimated immediately through a letter.
(ii)
Selection will be based on the applicant’s academic record and performance in the interview.
However, nomination of a candidate by the Embassy does not guarantee admission to any Indian college/university for the above courses. Confirmation of admission by the Embassy will be given only after receipt of the same from the concerned Indian University. Request for change of college/ institution or transfer of scholarship after placement will not be entertained. If candidates withdraw or reject the scholarship offered by the Embassy due to non-placement in a college/institution of their choice, they will be debarred from future scholarship of the
Embassy. iii) Submission of incorrect information/Incomplete application forms by the candidate may result in forfeiture of the scholarship at any stage. iv) Candidates belonging to Bara, Parsa, Rautahat, Dhanusa, Mahottari, Sarlahi, Makwanpur and
Chitwan districts should submit their applications to Consulate General of India, Shreepur, Birgunj.

(v) Similarly candidates of Siraha, Udaypur, Saptari, Sunsari, Morang, Dhankuta, Jhapa and
IIlam should submit their forms at Embassy of India, Camp Office, Biratnagar.
(vi) Candidates belonging to rest of Nepal should submit their application forms to Embassy of
India, Kathmandu.
4. Instructions for filling form:
(i) The ICCR’s application form and data sheet may be downloaded from the Indian Embassy website www.indianembassy.org.np
filled in legibly, preferably typed and should be strictly in the format as specified. ICCR’s forms in six copies and data sheet in one copy along with attested marksheet / transcript and citizenship certificate duly translated in English which should be certified by Notary Public. Originals need not be attached at this stage. ii) Forms may be submitted at only one place i.e. either at Embassy of India, Kathmandu or at
Consulate General of India, Shreepur, Birgunj or Embassy of India, Camp Office, Biratnagar alongwith the original counter foil of Bank Voucher, showing that the application fee of Rs.400/has been deposited in the Education Wing, EOI, Kathmandu’s Account No. 17725240200331 of any Nepal SBI Bank, anywhere in Nepal or Consulate General of India, Shreepur, Birgunj or
Embassy of India Camp Office, Biratnagar not later than February 7, 2013.
Forms will be accepted on all working days between 1000 hrs to 1200 hrs only. Application fee once deposited will not be refunded or adjusted in any case to the candidate.

To be submitted in 1 copy only along with marksheet /Transcript & citizenship)
Data sheet for AYUSH Scholarship Scheme 2013-14
Course applied for : __________________________________________
First name Middle name Last name
1. Name
2. Father’s Name & Occupation :
3. Full Correspondence Address :
:
4. District
5. Phone/Mobile No.
6. E-mail
7. Date of birth in Christian era
:
:
:
:
Affix recent
Passport size
Photograph
8. Age as on 01 July 2013 :_____Years___Month Days
9. Total Marks in class XII Marks Obtained in class XII % in class XII
____________ _____________ ________
10. Marks Obtained in English in class XII :
11. Total Marks in Graduation Marks obtained in Graduation % in graduation
____________ _____________ ________
11. I further understand that mere nomination of my name by EOI, Kathmandu does not guarantee admission to any Indian college/university for the above course . I will not request for change of college/ institution or transfer of scholarship on receipt of admission offer letter. If I withdraw or reject the scholarship offered by the Embassy due to non-placement in a college/institution of my choice, I will be debarred from future scholarship of the Embassy.
12. I certify that information/details furnished are correct to the best of my knowledge and belief. I am also aware that my application/selection/scholarship will be rejected/ annulled at any stage if any facts stated above are found to be incorrect/ incomplete.
Signature with date of submission

(To be submitted in six copies alongwith marksheet / transcript and citizenship duly translated in english & attested by Notary Pubic)
2 0 -
Name of scholarship scheme
Course applied for:__________________________________________________________
Please tick one of the following course options: ( ) UG ( ) PG ( ) Ph.D ( ) Ayush
Website: www.iccrindia.net

APPLICATION FORM
1. Full name (IN BLOCK LETTERS)
(Mr. / Mrs. / Miss)
2. Male ( ) Female ( )
3. Contact details:- i. Tel/Mobile: ii. Fax: iii. Email: iv. Postal address:
4. Permanent home address (IN BLOCK LETTERS)
5. Date of birth _______________ Nationality ______________________________
6. Country of residence _________________________________
7. Passport No. ______________________ i. Date of issue _________ii. Date of expiry _________iii. Place of issue ________
8. Details of Father / Guardian
Name:
Relation (F/G):
Occupation:
Nationality:
Address of permanent: residence of Father / Guardian

9. Knowledge of proficiency in English
Written Good ( ) Fair ( )
Spoken Good ( ) Fair ( )
Specify level of examination passed in English and grades obtained.
Poor ( )
Poor ( )
10. Knowledge of any other language __________________________________________
Written
Spoken
Good ( )
Good ( )
Fair ( )
Fair ( )
Poor ( )
Poor ( )
Poor ( ) Understand
11. Give details, if any
Good ( ) Fair ( )
(a) Proficiency acquired in games, sports & athletics; and
(b) Part taken in other extra-curricular of social activities
12. State in order of preference the Universities / Institutes in India in which you seek admission:
1.
2.
3.
NOTE: Please refer to University Grants Commission (UGC) website at http://www.ugc.ac.in
for
“Universities Handbook of India” Please note that ICCR provides scholarships only for courses in central or state government universities as listed by the
UGC, and for courses in deemed universities which have been approved by UGC.
There is no guarantee of admission in your choice of University / Institution. In case of nonavailability of a particular course in a particular Institution, the Council will forward the application to other Universities/Institutions where such courses are available.
The Council would try to accommodate the candidates as per their choice of course/institute. However, the Council reserves the right to offer admissions for any course or institution in India even if these are not among t he candidate’s preferred choice, while the candidate may decide whether or no to accept such an offer. it may noted that once accepted, no change in either course of University will be permitted.
13. State in order of preference the courses which you would like to study in India.
1.
2.
3.
NOTE: Candidate should be very specific and clear about the course of study, which he / she wishes to pursue in India. Scholarships are not available to pursue more than one course. Candidate should ensure that the courses listed here are offered by all three of the
Universities listed under S.No.12 above.

14. PREVIOUS EDUCATIONAL QUALIFICATIONS (Fill in all columns which are applicable to you):
Certificate / Degree Percentage
School Leaving
(equivalent to Grade
XII in India)
Country Name of School/ University /
Board
Year of
Graduation
(equivalent to three years course after grade XII in India)
Undergraduate
Post graduate
(Two years’ Masters’ course after the above mentioned undergraduate or five years’ Masters’ course after grade XII)
DOCTORAL (Ph.D)
(After Masters’ Degree)
Accepted
OR
Not yet accepted
Note: Details of any course in Indian Universities / Institutes which the scholar is currently attending or has attended in past may be given below.
Year Name of University / Institute Course

Give below the names of two persons who have agreed to testify from their personal knowledge to your character (they must not be related to you and should have direct knowledge of your academic pursuits and attach recommendation letters / character certificates signed by them).
(a) Name ________________________________________________
Status/ Designation ________________________________________________
Address ________________________________________________
E-mail ________________________________________________
(b) Name ________________________________________________
Status/ Designation ________________________________________________
Address
E-mail
________________________________________________
________________________________________________
15. Details of close relative (s) or friends, if any, in India.
I. Name
II. Relationship
________________________________________________
________________________________________________
III. Status/ Designation ________________________________________________
IV. Address
V. Tel No.
VI. E-mail
________________________________________________
________________________________________________
________________________________________________
16. Have you travelled or lived in India in the past. If so, mention places visited and dates of such visits.
17. Have you ever availed of ICCR Scholarship earlier? If so, please give full details.
(i) Year of Scholarship
(ii) Name of Course
(iii) Name of the Institute / University
(iv) Total duration of stay in India on scholarship
18. Any general remarks which you would like to offer (if the space is not sufficient, attach a separate sheet and sign the same).
Date
Place
Signature of Applicant
I hereby declare that the particulars given above are true to the best of my knowledge and belief, that I have understood the terms and conditions of the Scholarship Scheme as given above and hereby undertake to abide by them, and that I also undertake to return to my country after completion of my studies in India.
Signature of Applicant

CERTIFICATE OF PROFICIENCY IN ENGLISH LANGUAGE
Mr./Ms._______________________________________________is a scholar from NEPAL and has applied for the award of scholarship under the ___________________________________________scholarship scheme 20 -
He/she has been personally interviewed by me and I am satisfied that his/her knowledge of
English is sufficient to enable his/her to follow lectures and instructions given in English and to take examination in that language.
Signature _______________________________ Place________________
Date_________________
Designation with stamp_______________________________
Seal of the Indian
Diplomatic mission_________________________________________________________________

CERTIFICATE TO BE FURNISHED BY THE INDIAN DIPLOMATIC REPRESENTATIVE
Certified that I am satisfied
That Mr./Mrs./Miss_________________________________________________________
(Name of candidate) is permanently domiciled in___________________________________________________
(Name of country) and on completion of his / her studies in India will return to__________________________________________________
(Name of the country of domicile)
Certified that all entries in the application form have been checked with the original documents and that the application is complete in all respects. Attested copies of certificates, diplomas or degrees of examination passed are enclosed.
Date ____________________ Signature ___________________________
Place ___________________
Designation
with stamp __________________________

CERTIFICATE OF PHYSICAL FITNESS
(To be filled by a Registered Medical practitioner in the applicant’s country of domicile)
Name of Applicant ________________________________________________________
Age
Nationality
Address
________________________________________________________
________________________________________________________
________________________________________________________
Street /City
(Country)
________________________________________________________
________________________________________________________
Phone/Mobile No. ________________________________________________________
1. History (Please give details of any past medical condition which may adversely impact the patient’s health at the current time or in the near future).Symptom with (+) for positive findings and (-) for negative findings:-
Dephtheria Scarlet Fever
Rheumatic Fever Pneumonia
Typhoid
Small Pox
Malaria
Cholera
Tuberculosis
Vertigo
Scabies
Spots
Geng Headche
Ears Tinnitus
Nose
Cardiorespiratory System
Expectoration
Deafness
Obstruction
Chest Pain
Short of breath pain
Sweat
Epistaxis
Cough
Haemoptysis
Tachycardia
Type
Palpitation Night Sweat AIDS
IA. Give details of any injury, illness or operation during the past five years (be sure to list all illnesses or injuries), with dates (month and year) and duration of illness/ injury/ operation

2. Physical Examination
Medical condition of: - Height_________________Weight___________________
Chest_________ ________Describe abnormalities:________________________
Head__________________ Nose______________ Lungs____________________
Eyes__________________ Pharynk___________ Heart____________________
Ears__________________ Neck_______________ Reflexes_________________
3. Lungs
Comment more fully on condition of applicant’s lungs.
4. SUMMARY
1. I believe this applicant IS / IS NOT physically able to carry on a full course of study, involving long hours of work, in a college or university in India.
2. In my opinion the applicant’s health and physical condition in general are:
Excellent Good Poor
3. He/She was successfully vaccinated against smallpox on (Date)________________( )
4. He/She was successfully inoculated against smallpox on (Date) ________________( )
5. He/She has no physical defects which would hinder him from pursuing a full course of study in India. _________________( )
6. He/She presents no evidence of any communicable disease or of any chronic fatigue and has no physical defects. _________________( )
7. He/She does not have any chronic medical condition which requires regular and sustained medical treatment. ____________________ ( )
NOTE: If answers to 4, 5 and 6 above are positive, please give details in Remarks column below.
IV. REMARKS
Date
Signature_________________________
Address__________________________
_________________________________
IMPORTANT:
_________________________________
As a protective measure, those planning to study in India are strongly advised to get vaccinated against typhoid / cholera before coming to India.