[1]UGC-DAE Consortium for Scientific Research

KALPAKKAM NODE

Request for use of the facilities at the node

FOR OFFICE USE:

Project No.:

Date Received :

Contact Scientist :

Dates allotted: to

Report due date:

1. Investigator:

Name:

Designation:

Address:

Telephone:

Fax:

e-mail:

2. Title of the Experiment:

3. Brief description of the research problem, including the investigations which have already been done: (about 200 words)

4. Collaborators (if any, including UGC-DAE CSR personnel)

5. Has any discussion taken place with the scientist concerned at CSR (UGC-DAE)?

If so, mention salient points.

6. Details of the characterisation measurements already done on the samples:

7. Facilities to be used at CSR-Kalpakkam Node:

(give all the relevant details like temperature range, vacuum conditions, frequency range etc.)


8. Details of the samples to be measured:

(composition, form, number etc.)

9. Preferred dates (if any):

10.Details of financial support provided by sponsoring institutions for the experiment:

11.Whether financial support required?

(CSR provides financial support to the extent of sleeper class train fare and local hospitality. Such grants are limited in number)

12. Have you made use of the CSR facilities earlier:

Dates:

Facilities used:

Publications emerged out of the work:

Brief report on the work done (if not submitted earlier):

DECLARATION:

1. If the proposal is accepted, I will send two copies of a report on the work carried out at CSR to the Centre Director CSR, Indore Centre within one month of the work.

2. A copy of the resulting publication, if any, will be sent to Centre Director, CSR, Indore Centre.

3. Every such publication shall carry the following acknowledgement: “This work (part of this work) was performed at UGC-DAE Consortium for Scientific Research, Kalpakkam Node, Kokilamedu”. In addition, if we receive help from any of the CSR personnel, the same will be acknowledged suitably, either in the acknowledgements or as a co-author.

Place:

Date : (SIGNATURE)

______

Forwarded

Signature and Seal of

Forwarding Authority

______

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[1]This form complete in all respect is to be mailed to:

The Scientist-in-Charge, UGC-DAE Consortium for Scientific Research, Kalpakkam Node, Kokilamedu-603104, T.N (: (044) 24780500 ext 21919/21918 FAX: (044) 24780081; Email: