iccr form-2
TRANSCRIPT
-
8/3/2019 ICCR FORM-2
1/23
INDIAN
COUNCIL FOR
CULTURAL
RELATIONS
SCHOLARSHIPS FOR FOREIGN NATIONALS
Name of Scholarship Scheme
AZAD BHAVAN, INDRAPRASTHA ESTATE, NEW DELHI-110 002TEL: 23379309, 23379310, 23379315,
Fax: 00-91-11-23378783, 23378639, 23378647, 23370732
Website : http://www.iccrindia.org
Email: [email protected]
GENERAL
INSTRUCTIONS TO APPLICANTS
1
-
8/3/2019 ICCR FORM-2
2/23
1) Five complete sets of application forms are to be submitted to the Indian Mission.
2) Candidate should clearly mention the course and university to which he/she is seeking
admission. The applicants are advised to go through the Universities Handbook
available with our Mission before giving these details.ICCR would not be able to entertain a subsequent change in course of study or University
once admission of a scholar is confirmed and the scholar has arrived to join the course.
3) Certified copies of all documents should be accompanied with English translations.
A syllabus of the last qualifying exam application.
NOTE:
a) Students applying for doctoral/post doctoral courses or architecture should include asynopsis of the proposed area of research.
b) Students wishing to study performing arts should, if possible, enclose Video/audio
cassettes of their recorded performances.
4) Candidates must pass English Proficiency Test conducted by Indian Mission.
5) ICCR will not entertain applications which are sent to ICCR directly by the students or
which are sent by local Embassy/High Commissions in New Delhi.
6) Priority will be given to students who have never studied in India before.
7) No application will be accepted for admission to courses in medicine or dentistry.
8) Candidates may note that Indian universities/educational institutions are autonomous andindependent and hence have their own eligibility criteria. Forwarding of applications is
thus not a guarantee of admission. A scholarship is awarded only when admission is
confirmed by ICCR.
9) Students must carry a proper visa. Scholars for structured undergraduate and postgraduate
courses should carry full term Student Visas while for Ph.D. students Research Visasfor a specific period of 4-5 years is required. Students should ensure that they get the
correct visa from the Indian Embassy/High Commission. Govt. of India guidelines
stipulate that if a scholar arrives without proper visa and his actual admission at the
University/Institute does not materialize, he/she will be deported to his/her country.
In the case of students who require Research Visas, an additional application for the
Research Visa has to be filled and submitted in six copies alongwith six photographs &synopsis. Applicants may note that clearance of Research Visa can take as long as six to
eight months.
10) Before departing for India the scholars should seek a full briefing from the IndianDiplomatic Mission in their country about living conditions in India/the details of
2
-
8/3/2019 ICCR FORM-2
3/23
scholarship/the type and duration of the course to which he/she is admitted. Scholars
should inform the Indian Embassy/High Commission of their travel schedule well in
advance so that ICCR can make reception and other arrangements for them.
11) Hostel accommodation is not guaranteed and is an exception rather that an assured
facility. The accommodation allowance that ICCR gives, allows 2 to 3 students to chumup, and share a small flat.
12) Scholars are advised to carry some money to meet some incidental expenditure onarrival.
13) All intending candidates should in their own interest obtain a certificate that they are free
from AIDS prior to their departure for India. Even in India, the applicant would have togo for AIDS test before the admission is finally given to overseas scholars. In case any of
the nominees is found to be HIV positive in India the scholar will be repatriated
immediately and the Council would not bear any expenses on this account.
14) The scholars who are awarded scholarships should bring with them all documents
relating to their qualifications in original for verification by the respectivecollege/university at the time of admissions.
15) This application form contains a tear-out sheet at Appendix-7 titled Joining Report of
the Scholar. This form should not be submitted alongwith the main application. Instead,the Joining Report form should be removed and submitted to ICCR by the scholar in the
event the scholar has been granted scholarship and only after the scholar has joined an
educational institute in India. This form should be submitted with the required stamp &signature of the Institute authorities.
16) For information not available in the Universities Handbook or from the IndianMissions abroad, applicants are welcome to contact the ISD Division at any of the
following telephone/email address:-
1 Director (S) 23370118
2 Programme Director (ISD-I) 23370391
3 Programme Director (ISD-II) 23379364
4 Programme Director (AS) 233704135 Programme Officer's (ISD-I & II) 23370784
Email :-
[email protected]@iccrindia.org
INSTRUCTIONS TO CANDIDATES FOR FILLING THE APPLICATION FORM
3
-
8/3/2019 ICCR FORM-2
4/23
1) All entries except the signature in the application should, as far as possible, be
typewritten or in block letters.
2) Five copies of application properly tagged should be submitted.
3) All the five copies of the application should be accompanied by the following documents:i) A recent passport size photograph (taken not earlier than a year before the date of the
application) should be pasted on the application form in the space provided for the
purpose. The name should be written on the photograph for purpose of identification.
ii) Certified photostat copies of official records in triplicate from Secondary School,
Universities or Professional School, etc. attended.
iii) A certificate of physical fitness in the prescribed form (attached), Appendix-2
iv) Two certified copies of the syllabi, curricula, etc. of courses covered in schools, colleges,universities attended (except the Senior Cambridge, High Cambridge and London
General Certificate of Education examination) will full details. If this information is
not supplied, your application will not be considered.
v) Certified photostat copies of Certificate, Diplomas or Degrees of Examinations passed.
ORIGINALS SHOULD NOT BE SENT AS PAPERS ATTACHED TO THE APPL
ICATION AS THESE WILL NOT BE RETURNED TO THE APPLICANT.
vi) A certificate of Proficiency in English language (Appendix-3).
vii)Certificate copies of relevant pages of candidates valid passport.
4. One additional photograph not pasted to any form.
4
-
8/3/2019 ICCR FORM-2
5/23
CERTAIN IMPORTANT INSTRUCTIONS FOR FILLING UP OF THE FORM
1.Fill 1 letter per box and 1 box must be left empty between words. Only capital lettersmust be used while filling information in the boxes. For Example:
J A B H A T T
2. Important : The name of the scholarship scheme should be mentioned by the student atthe front page of the application form.
5
-
8/3/2019 ICCR FORM-2
6/23
APPLICATION FORM
1. Full Name (IN BLOCK LETTERS)(Mr./Mrs./Miss)
1. Sex (F/M)
2. Postal Address (IN BLOCK LETTERS)
3. Permanent Home Address (IN BLOCK LETTERS)
4. Date of Birth (a) Nationality
5. Country of
Residence
7. Passport No.
a. Date of Issue b. Date of Expiry
c. Place of Issue
8. Details about Father/Guardian
I N D O N E S I A
6
-
8/3/2019 ICCR FORM-2
7/23
(a) Name
(b) Relation (F/G)
(c) Occupation(d) Nationality
(e) Address of
Permanent
Residence of
Father/Guardian
9. Previous educational qualifications
(See attached Sheet)
10. Knowledge of proficiency in English
Written Good ( ) Fair ( ) Poor ( )
Spoken Good ( ) Fair ( ) Poor ( )
Specify level of examination passed in English and grades obtained.
11. Knowledge of any other languageWritten Good Fair Poor
Spoken Good Fair Poor
Understand Good Fair Poor
12. Give details, if any
(a) Proficiency acquired in games, sports & athletics and
(b) Part taken in other extra-curricular or social activities
13. State in Order of preference the courses which you
would like to study in India; Name of courses etc.(Candidate should be very specific and 1
clear about his course of study, which 2
he/she wishes to pursue in India. 3
Scholarships are not available for multiple studies).
14. The course which the scholar would like to
pursue in India
15. State in order of preference, the Universities/Institutes 1
in India in which you seek admission 2
(this column must be filled in by the candidate) 3
Please see list at Appendix. - 5* Please refer to Universities Handbook of India available with the Indian Diplomatic Mission
in your country. However there is no guarantee for admission in the choice ofUniversity/Institution. In case of non-availability of a particular course in a particular Institution,
the Council will forward the application to other Universities/Institutions where such courses are
available.
The Council would try to accommodate the candidates as per their choice of course/institute but
they must be prepared to join other institutes also if they are not found suitable in the institution
chosen by them.
16. PREVIOUS EDUCATIONAL QUALIFICATIONS:
I N D O N E S I A
7
-
8/3/2019 ICCR FORM-2
8/23
CERTIFICATE/DEGREE COUNTRY UNIVERSITY/
BOARD
YEAR PERCENTAGE
_____________________
SCHOOL ____(Grade XII)__
(To be filled by Student)
(For Office Use)
______________
(To be filled by
Student)
(For Office Use)
____________________
UNDERGRADUATE ______
(Three years course after Grade XII)
(To be filled by Student)
(For Office Use)
(To be filled by
Student)
(For Office Use)
____________________
POSTGRADUATE ________(Two years Masters course after the abovementioned undergraduate or five years
Masters course after grade XII)
(To be filled by Student)(For Office Use)
(To be filled byStudent)
(For Office Use)
___________________
DOCTORAL _____________
(After Masters Degree)(To be filled by Student)
(For Office Use)
(To be filled by
Student)
(For Office Use)
Note: Details of any course in Indian Universities which the scholar is currently attending or
has attended in past may be given below:
Year Name of Institution Course
17. Give below the names of two persons whom you have asked to testify from their personalknowledge to your character, etc. on the form prescribed for the purpose. (They must not
be related to you and should have direct knowledge of your academic pursuits).
8
-
8/3/2019 ICCR FORM-2
9/23
(a) Name ____________________________________________
Status ____________________________________________Address __________________________________________
(b) Name ____________________________________________Status ____________________________________________
Address __________________________________________
18. Name (s) and address (es) of close relative (s) or friends, if any, in India. (Also
indicate also relationship)
19. Have you travelled or lived in India? If so, mention places visited and dates ofsuch visits.
20. Have your ever availed of ICCR Scholarship? If so, give details.
21. Any general remarks which you would like to offer (if the space is not sufficient,
attach a separate sheet and sign the same).
Date
Place Signature of Applicant
I hereby declare that the particulars given above are true to the best of my knowledge and belief,
that I have understood the terms and conditions of the Scholarship Scheme and that I undertaketo return to my country after completion of my studies in India.
Signature of Applicant
9
-
8/3/2019 ICCR FORM-2
10/23
Appendix-1
CERTIFICATE TO BE FURNISHED BY THE INDIAN DIPLOMATIC REPRESENTATIVE
Certified that I amsatisfied
that Mr./Mrs./Miss _____________________________________________________(Name of candidate)
is permanently domiciled in _____________________________________________________
(Name of Country)and on completion of his/her
studies in India will return to ______________________________________________________
(Name of the country of domicile)
Certified that the entries in the application form, particulars about examinations passed, marks
and divisions obtained, subjects studied and the syllabi covered have been checked with theOriginal documents and that the application is complete in all respects. Attested copies of
certificates, diplomas or degrees of Examination passed are enclosed.
Date _____________ Signature ___________________________
Place _____________ Designation _________________________
10
-
8/3/2019 ICCR FORM-2
11/23
Appendix-2
(CERTIFICATE OF PHYSICAL FITNESS)(To be filled by a Registered Medical Practitioner
in the applicants country of normal residence)
Name of Applicant____________________________________________________________
Age ___________________________________________________________
Nationality _________________________________________________________
Address ___________________________________________________________
(Street and Number) ___________________________________________________________
(City) ___________________________________________________________
(Country) ___________________________________________________________
I. HISTORY
Check after each disease and symptom with (+) for positive findings and (-) for negative findings:
Scarlet Fever Diphtheria Tuberculosis
Rheumatic Fever Pneumonia Vertigo
Typhoid Malaria Scabies
Small Pox Cholera Spots
Geng Headache Deafness Epistaxis
Ears. tinnitus Obstruction Cough
Nose Chest Pain Haemoptysis
Cardiorespiratory system Short of breath pain Tachycardia
Expectoration Sweat Type
Palpitation Night Sweat AIDS
Give details of any injury, illness or operation during the past five years (be sure to list all
illnesses or injuries)
Month & Year Period of disability
Injury or illness from to
from to
11
-
8/3/2019 ICCR FORM-2
12/23
Operations. from to
II. PHYSICAL EXAMINATION
Medical condition of:- Height ____________________ Weight_____________________
Chest ___________________ __________________________ Describe abnormalities: _______
Head ___________________Nose _______________________Lungs _____________________
Eyes ___________________ Pharynx ____________________Heart _____________________
Ears ____________________Neck ______________________Reflexes ___________________
III. LUNGS
Comment more fully on condition of applicants lungs.
IV. SUMMARY
I believe this applicant IS/IS NOT physically able to carry on a full-course of study, involving
long hours of work in a college or university in India. In my opinion the applicants health and
physical condition in general are:
Excellent
Good
Poor
She/he was successfully vaccinated against smallpox on (Date)___________________________
She/he was successfully inoculated against smallpox on (Date)___________________________
She/he presents no evidence of communicable disease or of any fatigue and has no physical
defects.
REMARKS
Date _____________ Signature _____________________
Address ______________________
_____________________________
IMPORTANT:
12
-
8/3/2019 ICCR FORM-2
13/23
As a protective measure, those planning to study in India are strongly advised to get
vaccinated against typhoid/cholera before coming to India.
13
-
8/3/2019 ICCR FORM-2
14/23
Appendix-3
CERTIFICATE OF PROFICIENCY IN ENGLISH LANGUAGE
Mr./Mrs./Miss.
____________________________________________________________is a scholar from
____________________________________________________________
and has applied for the
award of a scholarship
under the
____________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___
He/She has passed the English Proficiency Test conducted by the Mission.
Place __________________________ Signature ___________________________
Date __________________________ Designation _________________________
Seal of the Indian
Diplomatic Mission _____________________________________________________________
14
-
8/3/2019 ICCR FORM-2
15/23
Appendix 4
TYPES OF SCHOLARSHIP SCHEMES
______SCHOLARSHIP SCHEMES_______________________________________________
1. Commonwealth Scholarship/Fellowship Plan
2. Cultural Exchange Programme Scholarship Scheme
3. General Cultural Scholarship Scheme
4. Bangladesh Scholarship Scheme
5. Sri Lanka Scholarship Scheme
6. Mauritius Scholarship Scheme
7. ICCR Scholarship Scheme for Dance and Music
8. Reciprocal Scholarship Scheme
9. Africa Day Scholarship Scheme
10. Okita Memorial Scholarship Scheme
11. Craft Instructors Scholarship Scheme
12. T.C.S. of Colombo Plan Scholarship Scheme
13. Aneurin Bevan
14. Silver Jubilee Scholarship Scheme
15. SAARC Chair/Fellowship Scheme
16. DADOO NAICKER
17. Meakong Ganga Cooperation
18. Aid to Maldives
19. AYUSH Scholarship for Bimstec Member Countries
20. Post Doctoral Mauritius Scholarship Scheme
21. Afghan Scholarship Scheme
15
-
8/3/2019 ICCR FORM-2
16/23
Appendix 5
LIST OF UNIVERSITIES AND OTHER
INSTITUTIONS OF HIGHER LEARNING1. University of Hyderabad, Central University P.O. Hyderabad - 500 046 Andhra Pradesh2. Maulana Azad National Urdu University, Gochibowli Hyderabad - 500 032 Andhra Pradesh3. Assam University, Silchar - 788 011 Assam
4. Tezpur University, Napaam, Tezpur - 784 028 Distt. Sonitpur Assam
5. University of Delhi, Delhi - 110 007 Delhi
6. Indira Gandhi National Open University, Maidan Garhi New Delhi - 110 068 Delhi
7. Jamia Millia Islamia, Jamia Nagar New Delhi - 110 025 Delhi
8. Jawaharlal Nehru University, New Mehrauli Road New Delhi - 110 067 Delhi
9. Mahatma Gandhi Antarrashtriya Hindi Vishwavidyalaya, Post Box No.16, Panchtila, Umri Village, Arvi
Road Wardha-442 001 Maharashtra10. Central Agricultural University, Iroisemba Imphal - 795 001 Manipur
11. North Eastern Hill University, P.O. NEHU Campus Mawkynroh Umshing, Shillong - 793 022 Meghalaya12. Mizoram University, Aizwal - 796 012 Post Box No.910 Mizoram
13. Nagaland University, P.B. 341, H.Q. Lumami Kohima - 797 001 Nagaland
14. Pondicherry University, R Venkataraman Nagar, Kalapet Pondicherry - 605 014 Pondicherry
15. Aligarh Muslim University, Aligarh - 202 002 Uttar Pradesh
16. Babasaheb Bhimrao Ambedkar University, Vidya Vihar Rae Bareli Road Lucknow - 226 025 Uttar
Pradesh- 17 -
17. Banaras Hindu University, Varanasi - 221 005 Uttar Pradesh
18. Visva Bharti, Santinik etan - 731 235 West Bengal
19. Central Institute of English & Foreign Languages, O U Campus, Hyderabad 500 007 Andhra Pradesh
20. Rashtriya Sanskrit Vidyapeetha, Tirupati - 517 507 Andhra Pradesh21. Sri Sathya Sai Institute of Higher Learning, Prasanthi Nilayam, 515 134 District Anantapur Andhra
Pradesh
22. International Institute of Information Technology, Gachibowli Hyderabad - 500 091 Andhra Pradesh
23. National Institute of Technology, Warangal - 506 004 Andhra Pradesh24. National Institute of Technology, Silchar - 788 010 Assam
25. Bihar Yoga Bharati, Ganga Darshan Fort Munger Bihar - 811 201 Bihar
26. Punjab Engineering College, Chandigarh Chandigarh
27. Indian Agricultural Research Institute, New Delhi - 110 012 Delhi28. Jamia Hamdard, Hamdard Nagar New Delhi 110 062 Delhi
29. National Museum Institute of History of Art, Conservation and Museology, Janpath New Delhi - 110 011
30. School of Planning and Architecture, 4, Block - B, Indraprastha Estate New Delhi - 110 002 Delhi
31. Shri Lal Bahadur Shastri Rashtriya Sanskrit Vidyapeeth, Katwaria Sarai, New Mehrauli Road New Delhi -
110 016 Delhi
32. TERI School of Advanced Studies, Darbari Seth Block, Habitate Place Lodi Road, New Delhi - 110 003
Delhi
33. Rashtriya Sanskrit Sansthana, 56, 57, Institutional Area Janakpuri New Delhi - 110 016 Delhi
34. Indian Institute of Foreign Trade, IIFT Bhawan, B-21, Qutab Institutional Area New Delhi - 110 016 Delhi35. Dharmsinh Desai Institute of Technology, Post Box No 35, College Road Nadiad - 387001 Gujarat
36. Gujarat Vidyapeeth, PO Navjivan, Ashram Road Ahmedabad - 380 014 Gujarat
37. Sardar Vallabhbhai National Institute of Technology, Surat - 395 007 Gujarat
38. National Dairy Research Institute, Karnal - 132 001 Haryana- 18 -
39. National Brain Research Centre, SCO 5, 6 & 7 Sector XV, Part-II Gurgaon - 122 001 Haryana
40. National Institute of Technology, Kurukshetra - 136 119 Haryana
41. National Institute of Technology, Hamirpur - 177 005 Himachal Pradesh
42. National Institute of Technology, Srinagar Srinagar J&K
16
-
8/3/2019 ICCR FORM-2
17/23
43. Birla Institute of Technology, Mesra Ranchi - 835 215 Jharkhand
44. Indian School of Mines, Dhanbad - 826 004 Jharkhand
45. National Institute of Technology, Jamshedpur Jharkhand - 831 014 Jharkhand
46. Indian Institute of Science, Bangalore - 560 012 Karnataka
47. Manipal Academy of Higher Education, Madhav Nagar Manipal - 576 119 Distt. Udupi Karnataka48. National Institute of Mental Health & Neuro Sciences, PB No.2900, Hosur Road Bangalore 560 029
Karnataka49. Swami Vivekananda Yog Anusandhana Samsthana, No.9, Appajappa Agrahara Chamarajpet Bangalore -
560 018 Karnataka
50. National Institute of Technology Karnataka, Surathkal P.O. Srinivasnagar - 575 025 Karnataka
51. Jawaharlal Nehru Centre for Advanced Scientific Research, Jakkur Campus Jakkur Bangalore - 560 064
Karnataka
52. National Institute of Technology, Calicut Kerala - 673 60153. Lakshmibai National Institute of Physical Education, Shaktinagar, Gwalior - 474002 Madhya Pradesh
54. Maulana Azad National Institute of Technology, Bhopal - 462 007 Madhya Pradesh
55. Indian Institute of Information Technology and Management, Gwalior Gwalior Madhya Pradesh
56. Bharati Vidyapeeth, Lal Bahadur Shastri Marg Pune - 411 030 Maharashtra
57. Central Institure of Fishries Education, PB No. 7392, Kakori Camp Jaiprakash Road Versova Mumbai 400
061 Maharashtra
58. Deccan College Post Graduate and Research Institute, Pune - 411 006 Maharashtra
59. Gokhale Institute of Politics & Economics, 846, Shivajinagar (DG), Pune - 411 004 Maharashtra60. Indira Gandhi Institute of Development Research, Gen. Vaidya Marg, Santosh Nagar Goregaon (E),
Mumbai - 400 065 Maharashtra61. Institute of Armament Technology, Girinagar, Pune - 411 025 Maharashtra
62. International Institute For Population Sciences, Govandi Sation Road Deonar Mumbai - 400 088
Maharashtra- 19 -
63. Tata Institute of Social Sciences, Sion - Trombay Road Deonar, Mumbai - 400 088 Maharashtra
64. Tilak Maharashtra Vidyapeeth, Gultekadi, Pune - 411 037 Maharashtra
65. Tata Institute of Fundamental Research, Homi Bhaba Road Mumbai - 400 005 Maharashtra
66. Symbiosis International Education Centre, Senapati Bapat Road Pune 411 004 Maharashtra
67. Padmashree Dr. D.Y. Patil Vidyapeeth, Vidyanagar Sector 7, Nerul Navi Mumbai 400 706 Maharashtra
68. Visvesvaraya National Institute of Technology, Nagpur - 440 011 Maharashtra
69. Dr. D.Y. Patil Vidyapeeth, Pimpri Pune - 411 018 Maharashtra70. Narsee Monjee Institute of Management Studies, Mumbai - 400 056 Maharashtra
71. National Institute of Technology, Rourkela - 769 008 Orissa
72. Kalinga Insitute of Industrial Technology, Bhubaneshwar Bhubaneshwar Orissa
73. Thapar Institute of Engineering and Technology, P B No.32, Patiala - 147 001 Punjab
74. Dr. B.R. Ambedkar National Institute of Technology, G.T. Road By Pass Jalandhar - 144 004 Punjab
75. Banasthali Vidhyapith, Banasathali -304 022 Rajasthan
76. Birla Institute of Technology & Science, Vidya Vihar Pilani - 333 031 Rajasthan
77. Jain Vishva Bharati Institute, Post Box No.6 Ladnun - 341 306 Distt. Nagaur Rajasthan78. Institute of Advanced Studies in Education, Gandhi Vidya Mandir Sardarshahr Rajasthan 301 401 Rajasthan
79. Malviya National Institute of Technology, Jaipur - 302 017 Rajasthan
80. Janardan Rai Nagar Rajasthan Vidyapeeth, Udaipur Rajasthan
81. Mody Institute of Technology and Science, Lakshmangarh, Sikar, 332 311 Rajasthan
82. Avinashlingam Institute for Home Science & Higher Education for Women, Coimbatore - 641043 Tamil Nadu83. Gandhigram Rural Institute, Gandhigram PO 624 302 Dindigual District T.N. Tamil Nadu
84. Sri Chandrasekharendra Saraswathi Viswa Mahavidyalaya, Enathur, Kanchipuram - 631 561
Kancheepuram District Tamil Nadu85. Sri Ramachandra Medical College and Research Institute, 1, Ramachandra Nagar, Porur Chennai - 600116
Tamil Nadu86. Vinayaka Mission's Research Foundation, NH 47,, Sankari Main Road, Ariyanoor, Salem - 636 308 Tamil Nadu
87. Shanmugha Arts, Science, Technology & Research Academy, Tirumalaisamudram Thanjavur 613402 Tamil
Nadu
88. Vellor Institute of Technology, Ranipet Katpadi Road Vellor 632 014 Tamil Nadu
17
-
8/3/2019 ICCR FORM-2
18/23
89. Sathyabama Institute of Science and Technology, Jeppiaar Nagar Old Mamallapuram Road Chennai -
600 119 Tamil Nadu
90. Bharat Institute of Higher Education & Research, 173, Agharam Road Selaiyur Chennai - 600 073 Tamil
Nadu
91. Amrita Vishwa Vidyapeetham, Ettimadai Post Coimbatore - 641 105 Tamil Nadu92. M.G.R. Educational and Research Institute, 121, G.N. Chetty Road T Nagar Chennai - 600 017 Tamil
Nadu93. National Institute of Technology, Tiruchirapalli Tamil Nadu
94. Meenakshi Academy of Higher Education and Research, No. 12, Vembuliamman Koil Street
Virugambakkam Tamil Nadu
95. Karunya Instituute of Technology and Sciences, Karunya Nagar, Coimbatore - 641 114 Tamil Nadu
96. S.R.M Institute of Science and Technology, 2, Veerasamy Street West Mambalam Chennai-600 033
Tamilnadu97. Allahabad Agricultural Institut e, Allahabad - 211 007 Uttar Pradesh
98. Bhatkhande Music Institute, I- Kaiserabagh Lucknow Uttar Pradesh
99. Central Institute of Higher Tibetan Studies, Sarnath Varanasi - 221 007 Uttar Pradesh
100. Dayalbagh Educational Institute, Dayalbagh Agra - 282 005 Uttar Pradesh
101. Indian Institute of Information Technology, Nehru Science Centre Kamla Nehru Road,
Allahabad 211002 Uttar Pradesh
102. Indian Veterinary Research Institute, Izatnagar Bareilly - 243 122 Uttar Pradesh
103. Motilal Nehru National Institute of Technology, Allahabad Uttar Pradesh104. Forest Research Institute, P.O.I.P.E. Kaulagarh Road, Dehradun 248195 Uttaranchal
105. Gurukula Kangri Vishwavidyalaya, Hardwar - 249 404 Uttaranchal106. National Institute of Technology, Durgapur West Bengal
107. Maulana Mazharul Haque Arabic and Persian University, Sandal Nagar, Mahendru, Patna - 800 006
108. Indira Gandhi Krishi Vishwavidyalaya, Raipur 492006
109. Acharya N.G. Ranga Agricultural University, Rajendranagar Hyderabad - 500 030 Andhra Pradesh
110. Andhra University, Waltair Visakhapatnam - 530 003 Andhra Pradesh
111. Dr. B.R. Ambedkar Open University, Prof. G. Ram Reddy Marg Road No.46, Jubilee Hills
Hyderabad - 500 033 Andhra Pradesh
112. Dravidian University, Kuppam - 517 425 Chitoor District A.P. Andhra Pradesh113. Jawaharla Nehru Technological University, Kukatpally Hyderabad - 500 072 Andhra Pradesh
114. Kakatiya University, Vidyaranyapuri Warangal - 506 009 Andhra Pradesh
115. Nagarjuna University, Nagarjunanagar - 522 510 Andhra Pradesh116. National Academy of Legal Studies and Research University, NALSAR University of Law, 3-4-761,
Barkatpura Hyderabad 500 027 Andhra Pradesh
117. Osmania University, Hyderabad - 500 007 Andhra Pradesh
118. Potti Sreeramulu Telgu University, Public Gardens, Nampally Hyderabad - 500 004 Andhra Pradesh
119. Sri Krishnadevaraya University, Anantapur - 515 003 Andhra Pradesh120. Sri Padmavathi Mahila Visvavidyalayam, Tirupati - 517 502 Andhra Pradesh
121. Sri Venkateswara University, Tirupati - 517 502 Andhra Pradesh
122. Andhra Pradesh University of Health Sciences, Vijayawada 500 030 Andhra Pradesh
123. Arunachal University, Rono Hills Itanagar - 791 112 Arunachal Pradesh
124. Assam Agricultural University, Jorhat - 785 013 Assam
125. Dibrugarh University, Dibrugarh - 786 004 Assam
126. Gauhati University, Gopinath Bardoloi Nagar Guwahati - 781 014 Assam
127. Babasaheb Bhimrao Ambedkar Bihar University, Muzaffarpur - 842 001 Bihar128. Jai Prakash Vishwavidyalaya, Chapra - 841 301 Bihar
129. Kameshwar Singh Darbhanga Sanskrit University, Kameshwar Nagar Darbhnaga - 846 008 Bihar130. Lalit Narayan Mithila University, Darbhanga - 846 008 Bihar
131. Magadh University, Bodh Gaya - 824 234 Bihar
132. Nalanda Open University, Reshmi Complex, 7th Floor Kidwaipuri Patna - 800 001 Bihar
133. Patna University, Patna - 800 005 Bihar
134. Rajendra Agricultural University, Pusa, Samastipur 848 125 Bihar
135. Tilka Manjhi Bhagalpur University, Bhagalpur - 812 007 Bihar
136. Veer Kunwar Singh University, Arrah 802 301 Bihar
18
-
8/3/2019 ICCR FORM-2
19/23
137. Vinoba Bhave University, P B No.31 Hazaribagh - 825 301 Bihar
138. Bhupendra Narayan Mandal University, Madhepura 852 113 Bihar
139. Panjab University, Chandigarh - 160 014 Chandigarh
140. Hidayatullah National Law University*, Civil Lines Raipur 492 001 Chhatisgarh
141. Guru Ghasidas University, Bilaspur - 495009 Chhattisgarh142. Indira Kala Sangeet Vishwavidyalya, Distt. Rajanandgaon Khairagarh - 491 881 Chhattisgarh
143. Pandit Ravishankar Shukla University, Raipur - 492 010 Chhattisgarh144. Goa University, Sub Post Office Goa University Galeigao Plateau Goa - 403 206 Goa
145. Bhavnagar University, Gaurishanker Lake Road Bhavnagar - 364 002 Gujarat
146. Dr. Babasaheb Ambedkar Open University, Near Dafnala, Shahibaug Ahmedabad - 380 003 Gujarat
147. Gujarat Agricultural Uiversity, Sardar Krushinagar Dantiwada Campus (Distt. Banaskantha) - 385 506
Gujarat
148. Gujarat Ayurved University, Jamnagar 361008 Gujarat149. Gujarat University, PB No.4010, Navrangpura Ahmedabad 380 009 Gujarat
150. Maharaja Sayajirao University of Baroda, Fatehganj Vadodara - 390 002 Gujarat
151. Hemchandracharya North Gujarat University, PB No. 21 University Road Patan - 384 265 Gujarat
152. Sardar Patel University, Vallabh Vidyanagar - 388 120 Gujarat
153. Saurashtra University, Univer sity Road Rajkot 360 005 Gujarat
154. South Gujarat University, University Campus Udhna Magdalla Road Surat - 395 007 Gujarat
155. Nirma University of Science & Technology, Sarkhej, Gandhinagar Highway, Village-Chharodi
Ahmedabad-382481 Gujarat156. Ch. Charan Singh Haryana Agricultural University, Hissar - 125 004 Haryana
157. Guru Jambeshwar University, Hisar - 125 001 Haryana158. Kurukshetra University, Kurukshetra - 136 119 Haryana
159. Maharshi Dayanand University, Rohtak - 124 001 Haryana
160. Chaudhary Devi Lal University, Sirsa Haryana
161. Dr. Y.S. Parmar University of Horticulture & Forestry, Nauni - 173 230 Distt. Solan Himachal Pradesh
Himachal Pradesh
162. Chaudhary Sarwan Kumar Himachal Pradesh Krishi Vishwavidyalaya, Palampur - 176 062 Himachal
Pradesh
163. Himachal Pradesh University, Summer Hills Shimla - 171 005 Himachal Pradesh164. Jaypee University of Information Technology, Waknaghat, P.O. Dumehar Kandaghat District-Solan-
173 215 Himachal Pradesh
165. Shri Mata Vaishno Devi University, Camp Office: 27 A/D, Gandhinagar, Jammu-180004 Jammu166. University of Jammu, Babasaheb Ambedkar Road New Campus, Jammu (Tawi) - 180 006 Jammu
and Kashmir
167. University of Kashmir, Hazbartbal Srinagar - 190 006 (J&K) Jammu and Kashmir
168. Sher-e-Kashmir University of Agricultural Sciences And Technology, Shalimar Campus, PB No.262
GPO Srinagar Srinagar 190 121 (J&K) Cam Office : Railway Road Jammu - 180 004 Jammu AndKas hmir
169. Birsa Agricultural University, Kanka Ranchi - 834006 Jharkhand
170. Ranchi University, Ranchi - 834 008 Jharkhand
171. Siddu Kanhu University, Santal Parganas, Dumka 814 101 Jharkhand
172. Kachchh University, CS-60 Jubilee Ground Bhuj 370 001 Kachchh
173. University of Agricultural Sciences, G.K.V.K. Campus Bangalore - 560 065 Karnataka
174. University of Agricultural Sciences, Krishinagar Dharwad - 580 005 Karnataka
175. Bangalore University, Jnana Bharathi Bangalore - 560 056 Karnataka176. Gulbarga University, Jnana Ganga Gulbarga - 585 106 Karnataka
177. Kannada University, Hampi, Vidyaranya Hospet Taluk - 583 276 Bellary Distt. Karnataka178. Karnataka State Open University, Kanasagangotri Mysore - 570 006 Karnataka
179. Karnataka University, Pavat Nagar Dharwad - 580 003 Karnataka
180. Kuvempu University, Gnana Sahyadri Shankaraghatta - 577 451 Shimoga Distt. Karnataka
181. Mangalore University, New Administrative Building Mangalagangothri Mangalore 574 199 Karnataka
19
-
8/3/2019 ICCR FORM-2
20/23
Appendix - 6
Indian Council for Cultural Relations
PERSONAL PARTICULARS OF THE CANDIDATE
1. Name in full (Capital Letters) ___________________________________________________Surname First Name Middle Name
2. Nationality __________________________________________________________________
3. Date of Birth (in Christian Era) __________________________________________________
Date Month Year
4. Parentage :
* (a) Fathers name in full (Capital Letters) together
with his nationality _____________________________________________________
Surname First Name Middle Name
* (b) Mothers name in full (Capital Letters) together
with her nationality _____________________________________________________
Surname First Name Middle Name
5. Name of Spouse in full (Capital Letters)together with his/her nationality (in case of
married persons only)._______________________________________________________
6. Contact Address
_____________________________________________________________________________
_
_____________________________________________________________________________
_
7. Permanent Address
_____________________________________________________________________________
_
_____________________________________________________________________________
_
8. Passport number, date and place of
issue and its validity if available.___________________________________________________
No. Date of Issue Date of Expiry Place of issue
9. Occupation __________________________________________________________________
20
-
8/3/2019 ICCR FORM-2
21/23
10. Whether previously visited India?
If so, date and place of previous visit. ______________________________________________
_____________________________________________________________________________
_
* Full name and not initials are required.
21
-
8/3/2019 ICCR FORM-2
22/23
Appendix - 7
INDIAN COUNCIL FOR CULTURAL RELATIONSAZAD BHAVAN, I.P.ESTATE, NEW DELHI 110002.
International Scholarship Division
JOINING REPORT OF THE SCHOLAR
1. Name of the scholar : ___________________________________________
2. Name of the scheme under
which selected : ___________________________________________
3. Country of domicile : ___________________________________________
4. Course of study : ___________________________________________
5. Date of leaving the country : ___________________________________________
6. Date of arrival in India : ___________________________________________7. Date of joining the
Institute/University : ________________________________________
8. Name of the Institute/
University where admitted : ___________________________________________9. Duration of the entire course : Date Month Year
From:
To:
10. Duration of summer vacation From:
To:
11. Name of the competent authority
allowance etc. should be sent. :12. Hostel or residential address
of the scholar at the place of
study in India. :.13. Passport number with validity
of the passport. : ____________________________________________
14. Whether allotted hostel
accommodation? If so,name of the hostel :____________________________________________
15. Roll No./Reg. No./ I.C. No. : ____________________________________________
_____________________________________________________________________________
_ Note: This page may be torn out and kept with candidate, Upon completion of all registration
formalities this form may be returned to ISD Section, ICCR in person or by post. Please ensure
22
-
8/3/2019 ICCR FORM-2
23/23
that the form is duly stamped and signed by concerned authorities in the Institution/ University
where the scholar joins.
14. COMPULSORY FEES : I II III IV VYR. YR. YR. YR. YR.
Tuition Fee : ________ ________ ________ ________
Admission fee : ________ ________ ________ ________Enrolment fee : ________ ________ ________ ________
Registration fee : ________ ________ _________ ________
Laboratory fee : ________ ________ ________ ________
College Exam. Fee : ________ ________ ________ ________University Exam. Fee : ________ ________ ________
________
Marks sheet fee : ________ ________ ________ ________Identity Card fee : ________ ________ ________ ________
Library reading room fee : ________ ________ ________ ________
Gymkhana/Games/Athletic fee : ________ ________ ________ ________Union fee : ________ ________ ________ ________
Association fee : ________ ________ ________ ________
Recreation fee : ________ ________ ________ ________Medical fee : ________ ________ ________ ________
Visual fee : ________ ________ ________ ________
Poor Student Aid fee : ________ ________ ________ ________
Name of any other feewhich is compulsory : ________ ________ ________ ________
Hostel rent
(Room rent, water & electricitycharges with break up) : ________ ________ ________ _ _______
Any other charges not covered above & details thereof:-
In case the scholar has not been allotted any hostel accommodation for himself due to
nonavailability of accommodation in the hostel, a certificate to this effect stating that This is to
certify that as no hostel accommodation was available, the scholar could not be provided hostelaccommodation and he/she had hired private accommodation for which he/she is paying
Rs._______ P.M. to the land lord may be sent to the Council separately.
Signature of Head of the Institute:
:_________________________________________
Name in Block letterDesignation and seal ________________________
______________________________________________________________________________
Important: Students may kindly note that in any future correspondence with ICCR, the name of
the country, scholarship scheme, year of joining and File Number must be mentioned.