Application form for Fellowship

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Building Energy Efficiency Higher & Advanced Network (BHAVAN)
Fellowships
Application Format for Fellowship
INSTRUCTIONS
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The application should be submitted in the prescribed format.
Application should not be more than 20 pages including CVs.
Candidates should submit the application along with supporting documents as a single
pdf document.
Applications in subject-fields other than those specified in the advertisement will not be
considered.
Please ensure to attach the following enclosures:
 Acceptance letter from host institute in the United States.
 Statement from the current employer as per the format indicated on Page 6.
 Recommendation letters.
Complete application should be submitted electronically to the Indo-U.S. Science and
Technology Forum (IUSSTF) at energy.fellowship@indousstf.org
1
APPLICATION SECTION I
1. Name (First name, Middle name, Surname):
2. Contact details (Postal address, Phone numbers and e-mail):
3. Date of birth (dd/mm/yy):
4. Gender (Male/Female):
5. Parent Institution (Name, Address and Phone number):
6. Designation:
7. Employment [Do you hold a regular position in your institute? (Yes/No)]:
8. Passport details:
 Passport number:
 Place of issue:
 Date of issue:
 Date of expiry:
9. Academic qualifications:
EDUCATIONAL QUALIFICATIONS (10th Standard onwards)
Examination/
University/
Degree
Board
Duration
Institute/
College/
School
(from
Subjects studied/
-age/
mm/yy to
Specialization
CGPA/
mm/yy)
2
Percent
Rank
10. Employment history:
EMPLOYMENT DETAILS (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)
11. Honours and awards received:
3
Brief job description/Nature of work
APPLICATION SECTION II
1. Proposed Topic/Title of research:
2. Host institute in USA:
3. Host Mentor in USA:
4. Contact of the U.S. Mentor (Postal address, Phone numbers and e-mail):
5. Proposed duration of the fellowship (Months):
6. Brief summary of your current areas of research:
7. Description of scientific work planned including: (not more than 3 pages)
(i) Specific need for the joint work (should not be confined only to access to instrumental
facilities):
(ii) Tangible outcome expected and its relation to present state of knowledge in the field:
(iii) Mutual scientific benefit to be accrued to both sides:
(iv) Follow up activities that may emerge towards a sustained collaboration:
8. State any other relevant aspects in the application which may be useful for the
reviewer to make a qualitative judgment on the application:
9. Details of international fellowships availed in the last three years:
S. No.
Address of overseas
Duration
institute
4
Agency
Brief
Achievement/
which
objective of
Outcome
sponsored
the work
the visit
done
10. Details of applications made/ pending for any other international fellowships:
S. No.
Address of overseas
Duration
Agency
institute
Brief objective of the work
done
11. Scientific projects with applicant:
S. No.
Title
Grant Period
Cost (Rs. in lakhs) Funding Agency
12. List of publications (last five years):
13. List of papers presented in conferences:
14. Brief CV of the applicant and the host US scientist (not more than 2 pages each):
15. References (The references should be provided on the official letter-heads of the
Referees).
REFERENCES
(Please furnish details of persons who can provide an assessment of your suitability for this fellowship)
Details
Reference 1
Reference 2
Name of Referee:
Designation:
Organization:
Email id:
Phone number:
Relationship with Applicant
5
STATEMENT FROM THE CURRENT EMPLOYER
(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 to the consideration of application for the
Building Energy Efficiency Higher & Advanced Network (BHAVAN) Fellowship Program
from
Mr./Ms./Dr………………………………………….employee
in
the
………………………(name of the department/institute/ organization) for research/ training 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 Building Energy Efficiency Higher & Advanced
Network (BHAVAN) Fellowship Program. 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.
Place:
Date:
(Head of Institution/Organization)
Official seal
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