Daryavardi ver 1.1

ENTRY FORM FOR INDIVIDUALS

Instructions :
              1: Limit the entries as indicated in the brackets.
              2: Avoid using special characters in the form.
              3: If the form is not accepted due to duplication then 
                 change the case of some characters in the form.
 


First Name(20)         :

Middle Name(20)        :

Last Name(20)          :

Title                :

Designation(20)        :

Affiliation(60)        :

Office Address       :
                           Building(20)           street(20)          city/town(20)          Pincode(6)
Residential Address  :
                           Building(20)           street(20)          city/town(20)         Pincode(6)
State/Union Territory:

Phone(s)(60)   +91 (0)   :

Fax(60)        +91 (0)   :

E-Mail(60)             :

URL(60)       http://    :

Date Of Birth        :   Sex :  Male  Female
                       dd-mm-yyyy





Educational Qualifications
Degree/Title Field/Subject Grade Year College/University Graduation : Post-Graduation : Ph.D. : Post-Doctoral : Any other : 
Field Of Research(45)      :
     

Subject keywords    :  Describing Your Main Activities : Select the most appropriate one
                      
                                                                                                                                            Scroll to see more codes 


Experience(Yrs.)          :




No.of Publications        :              
                           Indian        Foreign       Scientific     Non-scientific
  
No. of Patents            :    
                           Indian      International

No. of Copyrights         :    
                           Indian      International
                           

Present Field of Work(60)  :
     

Guidance                  :            
                           Graduation/      Doctoral        Post-doctoral
                         Post-Graduation 
No. of seminars attended  :      
                           Indian         International

Ship Cruise Time(Days)    :
 

Field Work Duration(Days) :


 No. of countries visited :


Mention a few of the countries visited(200):
                           

Institutions/Agencies worked abroad :
    
                              Name of the Institution/      Address of the       Worked from    Worked upto                             Guide                                                                                                                               
                                         Agency(30)          Institution(city)     dd   mm   yy  dd   mm   yy      First Name(20)        Middle Name(20)        Last Name(20)                                  Nature   of    the   work (200)                
                         1.
                         2.
                         3.
                         4.
                         5.  
Awards/Fellowships(4x30)    :
                           

                           
                           
Membership(of Forums/
            Societies)(4x25): 
                           
                           

Other Information(60)      :
The source of your main photograph(15)  :
 


 










 



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