ANNEXURE – I
APPLICATION FORM FOR FINANCIAL ASSISTANCE TO ATTEND CONFERENCE /SEMINAR ETC
- Details about the applicant
1 / Name of the applicant
2 / Designation
3 / Department
4 / Date of joining the University
5 / Faculty Code
6 / No of years served after lifting of probation
7 / Indicate the field of paper (to be presented) & its title, including authors
8 / Publication profile of the candidate in specified field (attach separate sheet)
9 / Whether a member of national / international professional body supporting the conference
[Attach the membership certificate, if member]
- CONFERENCE DETAILS
1 / Name / title of the conference
2 / Name of the organizers with complete address
3 / Name of the country/city/town where the conference will be held
4 / Whether the conference /event is supported by anybody. If so, specify and provide details of conference/ event
5 / Duration of the conference
[date / month / year (from – to)]
6 / Role of the applicant in the conference / symposia
Presenting / chairing the session (if yes, attach documentary evidence)
Delivering a plenary lecture / invited talk)
(if yes, attach documentary evidence)
Presenting a paper
(attach acceptance letter along with abstract)
9 / Indicate the amount of expenditure expected in attending the conference. Give brief break up.
10 / When was the last financial assistance received by the applicant for attending the conference / workshop/symposia under this policy?
Declaration from applicant
I, ……………………………………………, working as ……………………………….. in the department of ……………………………………………….certify that the details given above are correct and true to my knowledge. If the information supplied is found to be incorrect at a later date, I shall reimburse the entire amount to NCU. The amount received will be used for the purpose for which it is requested. In case financial assistance is received from the organizers / other agency later, I shall pay back an equivalent amount taken from NCU. I shall abide by the decision of the Committee of NCU.
Place:
Date:
Signature of the applicant
ANNEXURE – II
Proforma for claiming re-imbursement of the expenditure incurred under the travel grant scheme to attend conference/seminar/symposia in India or abroad and workshops/short term courses in India
- Name of the applicant:
- Name & place of the conference:
- Duration of the conference:
- Details of actual expenditure incurred on travel (attach TA Bill):
- Registration Fee Paid (Yes / No) [receipt enclosed] =
- Brief report of participation (enclosed Yes / No):
- Certificate of Attendance (Yes / No) (enclosed):
- Enclose copy of approval letter:
Certified that
- The details given above are correct and if the information is found to be incorrect on a later date, entire amount paid by the university will be refunded.
- The expenditure has been utilized for the purposes for which it has been approved in accordance with the terms and conditions laid down.
- In case financial assistance is received from the organizers or any other agency, an equivalent amount paid by the university will be refunded.
Signature of applicant
Name:
Certificate from Director SOET
- Certified that details given above have been verified and are correct.
- The applicant qualified for receiving financial assistance from the university as per the laid rules and guidelines.
Signature: ______
ANNEXURE – III
UTILIZATION CERTIFICATE
Certified that the expenditure of Rs. ………………………………………………………………. On the visit of ……………………………………………………………………………………… from …………………………………………… to ……………………………………………… present his / her paper at the ……………………………………………………………………… ……………………………………………………………………………………………………… has been incurred in accordance with term and conditions laid down by the University in its letter No. ………………………………………..….. dated…………………………… and all conditions of the grant have been fulfilled.
Hence, the above amount ……………………………may be released.
CFAO, NCU
(Name & Seal)
DSOET, NCU
VC:
GB:
1