APPLICATION FOR PREVEST ORIGINAL RESEARCH AWARD
Only this versOnly this version of the application form will be accepted.
Project
Project Title
Select Project Type
New Project
Continuation of Project
Keywords
(List up to five keywords)
1.
2.
3.
4.
5.
Primary Applicant
Applicant Name
Tile
First Name
Surname
Mr.
Mrs.
Ms.
Dr.
Qualification
Appointment / Practice Type
Institution
(If Applicable)
Department
(If Applicable)
Street Address
City
State
Pincode
E-Mail Id
Contact Nos.
Phone(Work)
Phone(Home)
Fax(Work)
Please Indicate if this applicant is in one of the following categories:
Private Practitioner
Senior Researcher
Postgraduate Student
Undergraduate Student
If Student, Name of the Research Supervisor
Is administration of the grant And correspondence the responsibility of this Applicant?
No
Yes
Hours Per Week Devote to the project
Hours
Brief Curriculum Vitae
Associate Applicant 1
Title First Name
Mr.
Mrs.
Ms.
Dr.
Surname
Qualification
Appointment / Practice Type
Institution
(If Applicable)
Department
(If Applicable)
Street Address
City
State
Pincode
E-Mail Id
Phone(Work)
Phone(Home)
Fax(Work)
Hours Per Week Devote to the project
Hours
Brief Curriculum Vitae
Associate Applicant 2
Title First Name
Mr.
Mrs.
Ms.
Dr.
Surname
Qualification
Appointment / Practice Type
Institution
(If Applicable)
Department
(If Applicable)
Street Address
City
State
Pincode
E-Mail Id
Phone(Work)
Phone(Home)
Fax(Work)
Hours Per Week Devote to the project
Hours
Brief Curriculum Vitae
Associate Applicant 3
Title First Name
Mr.
Mrs.
Ms.
Dr.
Surname
Qualification
Appointment / Practice Type
Institution
(If Applicable)
Department
(If Applicable)
Street Address
City
State
Pincode
E-Mail Id
Phone(Work)
Phone(Home)
Fax(Work)
Hours Per Week Devote to the project
Hours
Brief Curriculum Vitae
Where is the work to be undertaken?
Duration of Project
Commencement Date
(Date Format:DD-MM-YYYY)
Anticipated Completion Date
(Date Format:DD-MM-YYYY)
Note: For projects designed to be managed in stages over more than one year, it is necessary to submit a new application each year
What Technical/Other staff will be available to assist the project?
What are the Aims of the project?
Detailed Description of the project.
Browse Copy of the Publication
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