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APPLICATION FORM

Important:
(i) Separate application should be submitted for each event (Conference/ Seminar
/Symposium/Workshop/Training Program/Short-term school).
(ii) Age will be considered as on the Start date of the Event. Senior Scientists (More
than 35 years on the Start date of the Event)are eligible only for attending
Conference/Seminar or Symposium.
(iii) Complete application including all supporting documents must be completed only
between 60 to 90 days in advance with effect from the Start date of the Event.
(iv) Please attach the signed copies of the Endorsement of Institute and Certificate
from yourself with the Application Form.

A. Event Venue and Date


a. Start Date of Event:
b. End Date of Event:
c. Country of Event:
d. Full Name of Event:
e. City of the Event:
f. Name of the Organizer:
g. Website of the Event:

B. Purpose of Visit
a. Type of Event: Conference/ Seminar /Symposium/Workshop/Training
Program/Short-term school – Choose One.
b. Presenting Paper: Oral/Poster/Both/None Choose One
c. No. of Papers to be presented:
d. Whether Single Author/One of the Author:
e. Likely date of leaving India:
f. Likely date of return to India:
g. Event Benefit (200 words):

C. Category of the Event (See list Annexure-I)


a. Subject Category:
b. Sub Category:
D. Applicant Details
a. Name (including Title, Given Name and Surname):
b. Email Address:
c. Category (GEN/SC/ST/OBC):
d. Date of Birth:
e. Nationality:
f. Gender (Male/Female/Transgender):
g. Designation:
h. Department:
i. Telephone (O):
j. Telephone (R):
k. Mobile:
l. Fax:
m. Differently Abled (Yes/No)
n. Passport Number:
o. Aadhar ID:

E. Institution Details
a. State:
b. City
c. Name
d. Address
e. Pin Code

F. Education and Training


Degree Year University/Institute Subject %Age/Grade/Division
..
..

G. Significant Publications : (5 most significant papers published during the last 5 years in
relevance to the Event)
Authors Year Title of Paper Journal Volume Page
..
..

H. Anticipated Expenses Details


Mode of Travel Amount
Fare Both Ways
Visa Fees
Registration Fees (Applicable for Young Scientist only)
Total
I. Financial Assistance Details from Other Agencies (If applicable)
Agency Name Travel (in Rs.) Visa (in Rs.) Registration (in Status
Rs.) (Committed/Applied)

Total

J. Details of the International Events attended during last three years


Event Name From Date To Date City Country Sponsored/Funded
by

K. Any other information which you may like to furnish in support of your application (200
words)

L. Attachments Required
a. Bio Data
b. Partial Support Expenses (if Applicable)
c. Acceptance Letter
d. Abstract Paper
e. Event Detail
f. Endorsement of Head of the Institution (as per format available on SERB website)
g. Certificate of Applicant (as per format available on SERB website)
h. Date of Birth Certificate (for Young Scientist only)
Category of Events
Annexure – I

SNo. Subject Category Sub Category


Engineering Sciences a. Chemical Engineering
b. Electrical, Electronics & Computer Engineering
c. Materials, Mining & Minerals Engineering
1.
d. Mechanical & Manufacturing Engineering & Robotics
e. Civil & Environmental Engineering

Life Sciences a. Biophysics, Biochemistry, Molecular Biology &


Microbiology, Pharmaceutical Sciences, Biotechnology
b. Health Sciences
2.
c. Plant Sciences, Agronomy, Soil Science
d. Animal Sciences

Physical Sciences a. Condensed Matter Physics & Materials Sciences


b. Laser, Optics, Atomic & Molecular Physics
3. c. Plasma, High Energy, Nuclear Physics, Astronomy &
Astrophysics & Nonlinear Dynamics

Chemical Sciences a. Organic Chemistry


b. Inorganic Chemistry
4.
c. Physical Chemistry
d. Green Chemistry
Earth and Atmospheric a. Atmospheric Sciences
5. Sciences b. Earth Sciences
c. Himalayan Glaciology
6. Mathematical Sciences a. Mathematical Sciences
7. Multi Disciplinary a. Multidisciplinary