Indian Institute of Technology Ropar: Application Form For Admission To Institute Post Doctoral Fellowship Programme

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INDIAN INSTITUTE OF TECHNOLOGY ROPAR

APPLICATION FORM FOR ADMISSION TO INSTITUTE POST DOCTORAL


FELLOWSHIP PROGRAMME

Department/School

Area of Research
Affix Recent Passport
Size Photo

Personal Details
Full Name
(in Capital)
Father’s Name
(in Capital)
Date of Birth Category
(DD/MM/YYYY) (SC/ST/OBC/GEN)
Gender Marital Status Nationality
(Male/Female) (Single/Married)
Communication Address Permanent Address

Mobile Number Email ID

Details of Educational/Professional/Technical Qualifications (from Matriculation onward):


Sr. Regular/ %age of
Degree Discipline University/College Year Division
No. Part time Marks
1
2
3
4
5
6

If PhD degree not awarded, please give whichever applicable:

Date of thesis submission: ………………………………………


Likely date of submission: (in case not submitted yet) …………………………………
Title of Thesis ………………………………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………………………………………………………..

………………………………………………………………………………………………………………………………………………………………..

Specialization, in terms of Broad Area of Specialization and Exact Area of Specialization:


(a) Subject (b)Broad Area of Specialization Exact Area of Specialization

Publications and Patents: (Please attach list of publications and patents with full references and reprints or
photocopies bearing serial numbers corresponding with those in the list)

(a) No. of Papers (i) Published …………………………………(ii) Accepted ……………………………………


(b) No. of Books published ………………..,
(c) No. of patents: (i) Filed: ……………….. (ii) Granted …………………………………….

Prizes, Honours, Awards, Distinctions, if any: ………………………………………………………………………………………………


……………………………………………………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………………………………

Fellowships held:
Name of Name of the Date Amount Name of the
fellowship sponsoring From To Host Institute
agency
Give details of employment, if any
Sr. Period
Name of the Organization Designation Nature of Work
No. From To

Title of proposed Research and Development Project:


………………………………………………………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………………………………………….
(Describe in detail, on a separate sheet, the Research or Development Project you would like to pursue, along
with year-wise plan of work for at least two years. The project should be made in consultation with the
mentor with whom you propose to work)

Name of Faculty Member with whom proposed to work and his research group:

………………………………………………………………………………………………………………………………………………………………..

List of Enclosures: (Please tick)


1. Proof of thesis submission.

2. List of Publications.

3. Plan of work at IIT Ropar (two A4 pages maximum).

4. Recommendation letter 1 (from Supervisor)

5. Recommendation letter 2

DECLARATION
I hereby declare that I have carefully read the instructions and particulars supplied to me and that
the entries made in this application form are correct to the best of my knowledge and belief. If
selected for admission, I promise to abide by the rules and discipline of the Institute.
I note that the decision of the Institute is final with regard to selection for admission and assignment
to a particular Department and field of study/research. The Institute shall have the right to expel me
from the Institute at any time after my admission, provided it is satisfied that I was admitted on
false particulars furnished by me or my antecedents prove that my continuance in the Institute is
not desirable. I agree that I shall abide by the decision of the Institute, which shall be final.

Place:
Date: Signature of the Candidate

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