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1stAICTE-ECI CHHATRA VISHWAKARMA AWARDS 2017

To be given away on the Vishwakarma Day, 17th September, 2017, NEW DELHI

LAST DATE FOR ENTRIES | 25.08.2017

NOMINATION PROFORMA
Please read the eligibility criteria and objectives of each category before filling up the application form and carefully go
through the “Important instructions for submitting the nomination” section before submitting your application.

Award Category- Degree/Diploma Stream-


Civil/Electrical/Mechanical/Electronics/
Computer/ Biotechnology Engineering

(Please tick as appropriate)

A: For Nominee

Name of Team:

Names of Team Members:

Name of Single Point Of Contact (SPOC) of Team :

Address with PIN Code of SPOC:

Contact No. of SPOC (Land Line & Mobile)

E-mail of SPOC:

ECI National Register enrolment Number of Team Members (If any) :

1. Abstract (In max. 300 words) :

(Attach lists of equipment)


B: For Mentor/Teacher- Incharge
Name:

Designation:

Stream of Engineering:

Qualification:

Contact Details

Address with PIN Code:

Contact No. (Land Line & Mobile) :

E-mail:

S. Activity Number
No.
a) Number of UG/Diploma projects guided on similar area
during the last three years, List of ideas to be included.

b) Number of UG/ Diploma projects guided to solve problem of


society during the last three years, List of ideas to be
included.
c) Number of research publications during last three years

d) Student Feedback Index

e) Detail of achievement/award by students guided by the


Teacher
f) Number of Awards/Patents (if any)

C: For Institute
Name of Institute:

Permanent AICTE Id:

Address- City:
District:
State:

Name of Principal:

Contact No- Mobile:


Land line:

E-mail ID:

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