Nomination Application for Research Excellence & Academic Awards

"REAA-2019"

(Academic Institutions)

A: Award Details

Area of Award

Category of Award

Sub-Category of Award

B: Personal Information

Name of the Applicant

Date of Birth

Gender

Place of Birth

E-Mail ID

Nationality

Mobile No.

Year of Experience

Address for Communication

C: Employment Details

Name & Address of the Organization

Department/Division

Designation

Date of Joining

Website

D: Academic Qualification (Bachelor's & Above)

Degree

Discipline

Name of the Institution

Year

Class

E: Research/Constancy Projects

Title

Funding Agency

Amount

Duration

F: Patents Granted

Title

Inventor(s)

Patent No.

Date

G: List your current R&D Activities (word limit: 75 words)

H: Professional Accomplishments (Mention total numbers only)

Criteria

Status

Nos

Criteria

Status

Nos

Patents

Granted

Under Process

PhD/Masters Students Guided

Graduated

Current

Research Grants / Consultancy Projects

Completed

Sanctioned

Invited Presentations Delivered

Workshops

Conferences

SCI/SSCI Indexed Articles

Published

Accepted

Countries Visited

For Study

For Presentation

SCOPUS Indexed Articles

Published

Accepted

Awards Received

International

National

Declaration

I hereby declare that I have carefully read the regulations of the REAA 2019. I confirm that to the best of my knowledge, the
information given in this form is correct and complete. At any time I am found to have concealed/distorted any material
information, my application shall be liable to be summarily terminated without notice/compensation. I agree to CSERD to
process the data submitted in this application form, or any other data that the foundation may obtain from me for any
purposes connected with REAA 2019 for any other legitimate reason.

Any Other Matter you wish to report about the Institute/University: