Government of IndiaEntrepreneurship Development & Management

for Women Scientists & Technologists with the Government Sector

Sponsored by Ministry of Science & Technology, Department of Science & Technology, Govt. of India

Organised by Entrepreneurship Development Institute of India, Ahmedabad

NOMINATION FORM

NAME Prof./Dr./Ms.

DESIGNATION ORGANISATION DATE OF BIRTH

CONTACT NUMBERS /E-MAIL

CATEGORY (GEN/SC/ST/OBC) DATE OF ENTRY IN GOVT. SERVICE (AS GROUP ‘A’)

PRESENT PAY AND GRADE PAY COMPLETE ADDRESS/

EDUCATIONAL /PROFESSIONAL QUALIFICATIONS (GRADUATION ONWARDS)

SL. No.

YEAR

DEGREE

UNIVERSITY/INSTITUTE

RESEARCH EXPERIENCE

SL. No.

YEAR

TOPIC OF RESEARCH

SPONSORING AGENCY

CONTD..2

10 - 21, February 2020

Entrepreneurship Development

Institute of IndiaAhmedabad

Photograph

CURRENT LEVEL/GRADE:

Note: 1. Incomplete applying will be rejected 2. Please attach a copy of salary slip (latest)

thVIII National Training Programme on

EXPERIENCE / POSTINGS FROM LEVEL SCIENTIST ‘B’ ONWARDS (IN GROUP ‘A’)

SL. No.

NAME OF THE ORGANISATION

POST HELD

FROM

TO

TRAINING ATTENDED

SL. NO.

YEAR

NAME OF THE TRAINING PROGRAMME

NAME OF THE INSTITUTE

DURATION

SPECIFIC AREAS IN WHICH SKILL UPGRADATION DESIRED

1.

2.

3.

Signature of the candidateRECOMMENDATION BY THE CONTROLLING OFFICER

DATE: (SIGNATURE OF THE RECOMMENDING OFFICER)Name & Designation with Seal

thVIII National Training Programme on Entrepreneurship Development & Managementfor Women Scientists & Technologists with the Government Sector

Sponsored by : Department of Science & Technology, Govt. of India, New DelhiOrganized by : Entrepreneurship Development Institute of India (EDII), Ahmedabad

10 - 21, February 2020

Sr. No

Significant contribution made by you in the field of Science & Technology duringyour Service career (Max. 200 words).