Annexure III
(See Clause 11 (a) of Chapter II)
Application for ICHR General (Post-Doctoral) Senior Fellowship*

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Note: Please read the ICHR Research Funding Rules before filling this form.
Note: Applicants for Pay-protection Fellowships desiring to work for M. Phil/Ph.D. should fill Form in Annexure II and not this form.

Type or write legibly, preferably in block letters.

1. Applicant’s Name
(Block Letters)
Shri/Shrimati/Kumari

2. Date of Birth

3. Nationality

4. Postal address

5. Scholarships/fellowships previously received, if any, from ICHR or other such organizations.

6. Present post and scale of pay/post last held with scale

Present emoluments per month. (If the scholar is retired he/she should state the last salary drawn)

Basic salary:

Allowances:

7. Proposed topic of research
Please attach detailed synopsis, giving present state of knowledge in the field, your hypotheses, intended means of collecting information and checking the hypotheses, with a note on source material to be used and your ability to handle language(s) of the sources, a bibliographical note and a chapter-plan.
This should also justify particulars required under item no. 10.
Note: Giving full statement covering the above is essential.

8. Academic record beginning with Secondary School:

9. Languages known:
10. Previous research experience:

(a) Period
(b) Titles of books, papers published, if any

11. Institution of affiliation

(College, University, Research institute, etc.)
(Attach certificate that the institution is willing to act as the institution of affiliation)

12. (i) Whether the applicant belongs to SC/ST/OBC/Physically Challenged category if so, a certificate may be produced to this effect.
(ii) Whether the applicant has/had applied for financial support elsewhere for the same research proposal. If so, particulars may be given.
13. Following documents where applicable have to be attached by the applicant:
(i) A certificate from the Head of the Department/Institution of affiliation to the effect that necessary facilities for work will be given
(ii) Bio-data (three copies):
(iii) Detailed synopsis of the topic of research (three copies):
(iv) Published papers, if any:
(xeroxed copies may be appended or full references given)

14. Applicant for Post-doctoral Fellowship should give the following additional information:

(a) Year of award of Ph.D. degree.
(b) Name of the awarding University
(c) Title of the thesis

(d) Present occupation

Declaration

I hereby declare that:

1. The entries made in the form above and the additional particulars furnished by me are true to the best of my knowledge.

2. I have read the rules regarding the award of Fellowships of the Indian Council of Historical Research. In the event of the Fellowship being awarded to me, I shall fulfil all the requirements of the Fellowship, and agree to refund to the ICHR all expenditure incurred by me over the Fellowship, if the work of the Fellowship is not properly carried out or is not completed.

3. If selected, I will work on a whole-time basis for the Fellowship and will not accept any other Fellowship, financial assistance or employment except in accordance with the ICHR’s Research Funding Rules.

Place: Signature of the Candidate

Date:

For use by University/College/

Institution of affiliation

Recommendations of the forwarding authority:

Place: Signature

Head/Registrar/Principal/Head

University/College/Institution

(Views of a senior scholar or Head of the Department regarding the candidate’s suitability for the award may be obtained separately and enclosed with the application.)*