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Application Form Bose

This document contains an application form for the S.N. Bose Scholars Program. The form requests basic personal information from the applicant such as name, date of birth, passport details, contact information, as well as academic details including degree program, GPA, expected graduation date, educational history, research interests, experience, and reference letters. It also includes a section for a no objection certificate that must be provided from the applicant's home institution to confirm approval for a 10 week research internship through this program in the US.

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Siddharth Rawat
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127 views5 pages

Application Form Bose

This document contains an application form for the S.N. Bose Scholars Program. The form requests basic personal information from the applicant such as name, date of birth, passport details, contact information, as well as academic details including degree program, GPA, expected graduation date, educational history, research interests, experience, and reference letters. It also includes a section for a no objection certificate that must be provided from the applicant's home institution to confirm approval for a 10 week research internship through this program in the US.

Uploaded by

Siddharth Rawat
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Application Form S.N.

BOSE SCHOLARS PROGRAM 2013

1. Name: First name Surname 2. Male Female

Middle name

3. Date of Birth (dd/mm/yy): 4. Passport number: Country: Expiration Date: Date Issued: If you do not have a passport and have applied for it, mention Applied For 5. Name of the University/Institution: 6. Address:

Institution / University Address Residential Address Landline Number # Telephone Alternative Telephone No. E-mail Skype id Mobile #

7. Major field of study: 8. Degree program currently enrolled in (e.g., BS, MS, B.Tech., MBBS, M.Tech., Integrated BS/MS):

9. Cumulative Grade Point Average / Percentage: 10. Expected date of Graduation (Completion of Degree): ____(mm) ____(yy) 11. Academic Record:
EDUCATIONAL QUALIFICATIONS (10th Standard onwards) Examination/ Degree University/ Board Institute/ College/ School Duration (from mm/yy to mm/yy) Subjects studied/ Specialization Percentage/ CGPA/ Rank

12. Statement of Purpose: Research interests, possible project ideas and what you hope to gain from this experience (Please restrict your response to the space given below)

13. Research experience, technical background, other internships, courses, lab work, techniques exposed to and past lab experience (Please restrict your response to the space given below)

14. References (One of the referees should be your teacher/tutor. In case you have completed a training/internship in any lab, a reference from your supervisor there would be preferred. 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 internship) Details Name of Referee: Reference 1 Reference 2

Designation: Organisation: Email id:


Phone number: Relationship with Applicant

15. Signed and stamped no objection certificate from Parent InstitutionThis should be given on the official letter-head of the parent institution/organization in the following format: STATEMENT FROM PARENT INSTITUTION This is to certify that this institution has no objection to the consideration of application for S.N. Bose Scholars Program from Mr./Ms ..bonafide B.Tech./ M.Tech./ M.Sc. student in the (name of the department/institute/ organization) to undertake a research internship for the duration of 10 weeks at a U.S. university affiliated with the S.N. Bose Scholars Program.

Place & date:

(Head of Institution/Organization)

16. Supporting Documentation check-list: Current transcript (Latest Marks sheet) Two letters of recommendation from a faculty member, advisor or lab supervisor on their official letterhead No objection certificate from Parent Institution (in the format provided in S.No. 16) Photocopy of photo and information page of passport 5

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