NIGIS CAA - 2015- Laboratory Application

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Section

B

A

B

1

Applicant's Letter

NIGIS Form - General Particulars

Applicant's Essential Enclosures

A 01 Proof of Registration / Incorporation of Laboratory

A 02

Recommendation Letters

A 03 Resume (max 300 words)

NIGIS Form - Confidential (to be filled in by the authorized person without mentioning name of Laboratory anywhere in this Form)

Objectives

B 2

Technical Competence

B 2.1

Certification / Approval of Laboratory / Tests

B 2.2

Manpower / Equipment & Facilities

B

B

3

3.1

Experience - Last 5 years

Test Conducted and Research Projects carried out

B

B

4

5

Publications & Special Contributions (Last 5 years)

Corrosion Awareness/Promotion Activities or Awards

(Last 5 years)

B 5.1

Memberships of Corrosion Institutions /Societies

B

B

B

B

B

B

5.2

5.3

B

2.1

2.2

3.1

4

Participation in Corrosion related Conferences / Seminars/Events

Awards for Contributions to Field of Corrosion / etc.

Applicant's Enclosures (with Enclosure Nos. written on all pages and Applicant 's name written only on top of first page of

Enclosure)

B 01 Copy of Certificate of Certifying / Approving Authority

B

B

02

03

List of Test Equipment / Facilities

List of Test and Projects carried out

B 04

List of Publications

B

B

B

B

4

5.1

5.2

5.3

B

B

B

B

05

06

21 st

CORROSION AWARENESS AWARDS 2015

Application Form

Excellent Public / Private Sector Laboratory

CONTENTS OF APPLICATION

Details Sheets Remarks

(to be filled in by NIGIS)

07

08

List of Technical Research Contributions

List of Membership of Corrosion Institutions /

Societies

List of Corrosion Conferences / Seminars

Participated

List of Awards received for Contribution to Field of

Corrosion

21 st

CORROSION AWARENESS AWARDS 2015

Application Form

Excellent Public / Private Sector Laboratory

Application No. (To be filled by NIGIS) ............................

SECTION– A : GENERAL PARTICULARS

1.

2.

AWARD APPLIED FOR

GENERAL

Name of Laboratory

Laboratory

Address

Person Submitting

Application

Name

Designation

Address

Preferred Address for

Communication

Date of registration /

Incorporation

Public / Private

City

Pin:

Phone

Mobile

Email

City

Pin:

Phone

Mobile:

Email:

Lab Person

State

Fax

State

Fax

3. ESSENTIAL ENCLOSURES

A-01 - Proof of

Registration / Incorp

A-02 - Recommendation

Letters

A-03 - Resume

(max 300 words)

Enclosed Yes No

I confirm that all information given and enclosed is true to best of my knowledge.

Signature Date

21 st

CORROSION AWARENESS AWARDS 2015

Application Form

Excellent Public / Private Sector Laboratory

SECTION - B: CONFIDENTIAL PARTICULARS

(To be filled in by applicant without mentioning his / her name anywhere)

1. OBJECTIVES (According to Memorandum / Articles of Establishment of Laboratory)

Yes / No

SN

Objectives

1

2

3

4

5

6

Monitoring, Testing , Evaluation of performance and quality of materials

Research and Development related to

Objective-1 & Corrosion Control

2. TECHNICAL COMPETENCE

2.1 Certifications / Approvals of Laboratory / Tests

ONLY INTERNAL

OTHER

CUSTOMERS

SN Main Tests Standard

Certified / Approved by

International

Authority

National

Authority

1

2

3

4

5

6

2.2 Manpower / Equipment & Facilities

Key Personnel

SN Designation Nos. Education

Minimum Maximum

1

Experience, years

Minimum Maximum

2

3

4

5

6

2. EXPERIENCE (Last 5 years)

Main Equipment

Name Make Quantity Age in years

Format for presentation of details to be given under

Enclosure B-02

Private Sector Projects

Number Value, Rs

SN Details

1

2

3

4

Tests listed under Section

2.1 above

Tests other than that listed under Section 2.1 above

Research & Development

Projects - Test Equip /

Procedures

- Materials

- Corrosion

- Failure Analysis

- Others

Works related to any other any Objectives

In-House Projects

Number Value, Rs

Public Sector Projects

Number Value, Rs

4. PUBLICATIONS & SPECIAL TECHNICAL CONTRIBUTIONS (Last 5 years)

SN

1

2

Books

Publications

Details

Full Books

Chapters in multi-author

Books

Nos.

SN

Special Technical

Contributions

1

No. of

Improvements

Papers Presented in

2

No. of

Developments

Test Equip &

Procedures

Material

Performance

Corrosion

Control

Other

National Conferences

3

Foreign Conferences

No. of

Indigenization

3 Papers Published in

4

4

National Journals /

Magazines

Foreign Journals /

Magazines

Awards for Papers

5

No. of

Implementation

No. of Patents

National

Others, if any

Foreign

6

SN

1

5

6

2

3

4

5. CONTRIBUTION TO CORROSION AWARENESS / PROMOTION ACTIVITIES OR AWARDS

5.1 Membership of Corrosion Related Institutions / Societies

Society / Institution

/ Organization Type

Membership

From To

Present Office Bearer

Position Since Yr

Past Positions /

Specific Contributions

5.2 Participation in Corrosion Related Conferences / Seminars / Events (Last 5 years)

SN Conference /

Seminar / Event

No. of conferences / Seminar / Events participated during the last 5 years as

Sponsor Organizer Invited Guest Invited Speaker Author Delegate

1 NIGIS- CORCON

2 NACE International

3

4

5

6

5.3 Awards for Contributions to Field of Corrosion & Corrosion Awareness Promotion (Last 5 Years)

SN Society / Institution /

Organization

Year Event & Place Name of Award

1

2

3

4

5

6

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