Ref. Code : Feb13_148
(For office use)

National Photonics Fellowship of India
Tata Institute of Fundamental Research,
Homi Bhabha Road, Colaba, Mumbai 400 005.

Telephone: 022-22782716

Fax: 022-22804610/4611

E-Mail : gurav_sushma@yahoo.com

 Website http://www.photonicsindia.org

Application for the National Photonics Fellowship (Feb. 2013)
1
a) Full Name (Ms/Mr) * :
b) Date of Birth * : (DD/MM/YYYY)  
c) Place of Birth * :
d) Nationality * :
2
I have completed or will be completing my highest degree     in  
Engineering (specify branch) :
Other (specify degree and subject) :
3 If you have any questions or comments, add it here
 
4
Address for
correspondence * 		:
5
Phone no. : (STD)  (Number)
6
Mobile Number * :  
7
E-mail address * :      
8. Educational Details: (Please provide all possible details.)
Degree/ Exam College/ School University/ Board Year Class % Marks
or Grade 		Univ. Rank Science/Engineering Subjects
Std.X / SSC or equivalent*
Std.XII / HSC or equivalent*
OTHER
If you are in a program such as Int. M.Sc. and have not completed any college degree yet, please put your cumulative performance till date in the row marked "other".
9. When do you expect to complete M.Sc. / B.Sc.(Engg.) / B.E. / B.Tech. / M.E./ M.Tech / any other degree (specify)?*  
 
I expect to complete my (final) degree in
I have completed my (final) degree in
10 If you have already obtained your degree, state what you have been doing since then:
 
11
Are you NET (Research) qualified?
12 Have you previously appeared for the Photonics Fellowship Programme?*
 
Ref. Code (if available) I applied in (month/year):
13 Have you applied for/are the recipient of any fellowship?*
 
I applied in Fellowship Name
14 Special photonics related subjects studied* :
 
15 Publications (if any)
 
16 Research experience (if any)
 
17 Details of previous employment (if any)
 
18 Names, addresses and email ids of two Referees who will be required to fill up the referee reports in case you are shortlisted for interview. (They should be your teachers or persons with whom you have interacted academically).
 
Referee 1 * Referee 2 *
19 Any additional academic information about yourself that has not been covered above: (These may include awards, scholarships or any special academic achievements. You may enclose copies of any scientific article, paper or report on an original project that you may have written.)
 
20 How did you learn about the National Photonics Fellowship Program ?  
 




        
Date : 23/08/2017
This form should be submitted through the website.
You are encouraged to send any correspondence electronically to gurav_sushma@yahoo.com, but if deemed necessary, correspondence can be sent to:
Prof. Sudipta Maiti (Coordinator, National Photonics Fellowship)
Dept. of Chemical Sciences, Tata Institute of Fundamental Research
Homi Bhabha Road, Colaba
Mumbai 400 005.
Ph. 022 2278 2539, e-mail: maiti@tifr.res.in