Step by Step Instructions to fill the Online Application form: 1. Clicking the SAVE AS DRAFT button will only save the form filled so far. Please note that this does not mean that your form has been submitted. You can save your progress any number of times before clicking the SUBMIT button, which will finally submit the form. 2. An applicant can t submit the form unless all compulsory fields have been filled and all required documents have been uploaded. 3. Once submitted the form can t be altered without providing special admin rights that will be controlled by the backend team/cii 4. Field marked with * are mandatory fields. STEP 1: Personal Details Prefix* First Name* Middle Name Last Name* Gender* Date of Birth* Email* Mobile* Select your name Prefix. Enter your First name. Note: The name you enter here must be exactly what will be used for all official documentation and can t be changed. Be careful with what you enter as your First, Middle & Last name. Enter your middle name (Not compulsory) Enter your Last name. Select your gender. Click on the box provided and you can select the date month and year from the calendar. Enter your valid personal Email Id. Note: This email ID will be used for all future correspondence hence be very careful while keying this in. Enter your 10 digit mobile No. (Don t append 0 or +91 before your No.). Note: We will be contacting you on this number for any requirements. So be very careful while keying this in.
Father s name* Marital status* Nationality* Passport size photo* Enter your father s full name. Select your marital status. Select your nationality. Attach your Passport size photo in.jpg,.png format. Complete Permanent Address State* Pin code* Enter your permanent address. Select your state. Select your city. Note: If your city is not found then select Other option. And give your city name in the field provided for the. Enter your 6 digit pin code. Complete Postal Address(Select check box if same as permanent Address) State* Enter your postal address. Select your state. Select your city. Note: If your city is not found then select Other option. And give your city name in the field provided for the.
Pin code* Enter your 6 digit pin code. Step 2: Details of PHD Date of Enrolment in PHD* Date of Registration in PHD* Click on the box provided and you can select the date month and year from the calendar. Click on the box provided and you can select the date month and year from the calendar. Note: This date may be the same as enrolment date in case of some institute / university rules A candidate is eligible to apply for PM Fellowship if she/he has been registered for PhD for not more than 14 months from the date of submission of application PHD Enrolment certificate* PHD Registration certificate* Institute where enrolled / registered in PHD* University Nature of PHD enrolled/registered in* Attach the PHD Enrolment certificate in DOC format. Attach the PHD Registration certificate in DOC format. Enter name of Institute where enrolled / registered in PHD. Enter the name of University (Not Compulsory). Select the nature of PHD enrolled/ registered. Enter the address of institute. State* Pin code* Select the State. Select your city. Note: If your city is not found then select Other option. And give your city name in the field provided for the. Enter the 6 digit pin code.
Broad Research Area* Sub Classification Area* Research Topic* Research Synopsis* Select the Broad Research Area from the six listed areas of Life Science, Engineering, Mathematics, Physics, Chemistry and Earth & Atmospheric Sciences Enter the sub classification of research area E.g. Civil Engineering, Agriculture, Medicine etc. Enter the research topic. Note: Please do not enter a very long research topic. Keep it concise. This is the topic of research that you propose to work on under PM Fellowship Scheme. Enter your research synopsis. Note: The research synopsis should not be more than 300 words. The synopsis should reflect clarity of thoughts and objective. Try to highlight the importance of the research to industry. List of publications Enter the publication List. Step 3 Educational Details Details of 10 th Board Board* Subjects Taken* Year of Passing Percentage obtained in 10 th * Upload scan copy of your 10 th certificate* Select your board (If you select Other then define your board). Enter your 10 th subjects. Select passing year of 10 th board. Enter your percentage in 10 th Note: Do not enter best of 4 or best of 5 etc. Upload scan copy of your 10 th certificate in DOC format. Details of 12 th Board
Board* Subjects Taken* Year of Enrollment* Year of Passing Percentage obtained in 12 th * Upload scan copy of your 12 th certificate* Select your board (If you select Other then define your board). Enter your 10 th subjects. Select enrollment year of 12 th Board. Select passing year of 12 th board. Enter your percentage in 12 th Do not enter best of 4 or best of 5 etc. Upload scan copy of your 12 th certificate in DOC format. Details of Graduation Degree Name of Graduation Degree* Type of Graduation Degree* Specialization* Subjects* Total Percentage / CGPA Scored* Institute* University Year of Enrollment* Year of Passing Enter your graduation degree name. E.g. B. Sc., B.Tech etc. Select graduation type. Enter Graduation specialization E.g. Pharmacy, Physics, Mechanical Engineering Enter subjects taken in Graduation E.g. In B.Sc (H) Biochemistry, you may have taken Immunology, Microbiology, Biomolecules, Mathematics, Chemistry etc. as subjects. Enter the total percentage marks or CGPA, as applicable, scored in Graduation. Do not enter best of 4 or best of 5 etc. Enter your graduation institute. Enter your graduation university (Not compulsory). Select enrollment year of Graduation. Select passing year of Graduation.
Upload scan copy of your graduation certificate* Upload scan copy of your graduation certificate in DOC format. Select if you taken admission in PHD directly after Graduation Details of Post Graduation Degree Name of Post Graduation Degree* Specialization* Subjects* Total Percentage / CGPA Scored* Institute* University Year of Enrollment* Year of Passing Upload scan copy of your post graduation certificate* Enter your post graduation degree name. Enter post Graduation specialization. Enter post Graduation subject. Enter the total percentage marks or CGPA, as applicable, scored in Graduation. Do not enter best of 4 or best of 5 etc. Enter your post graduation institute. Enter your post graduation university (Not compulsory). Select enrollment year of post Graduation. Select passing year of post Graduation. Upload scan copy of your post graduation certificate in DOC format. Details of Other degree/diploma (not compulsory) Name of Other Degree Specialization Subjects Enter your other degree name. Enter other degree specialization. Enter other degree subject.
Total Percentage / CGPA Scored* Institute University Year of Enrollment Year of Passing Upload scan copy of your Other degree certificate Enter the total percentage marks or CGPA, as applicable, scored in Graduation. Do not enter best of 4 or best of 5 etc. Enter your other degree institute. Enter your other degree university (Not compulsory). Select enrollment year of other degree. Select passing year of other degree. Upload scan copy of your other degree certificate in DOC format. STEP 4 Host Institute (PHD) Details Name of institute where Registered for PHD* Name of Department* State* Pin code* PhD Institute STD Code* PhD Institute Phone No.* PHD Institute Website* Upload profile of Host Institute* Do you avail the hostel facility at your institute* Address Enter the institute name Enter the name of department Enter the Address Select the State Select city. If city is not found then select Other option. And give city name in the field provided for the. Enter city name in case of Other Enter the 6 digit Pin code Enter the STD Code for the Phone No. Enter the valid phone no. Enter the valid website URL (not including HTTP) Attach Profile of host institute in DOC format. Select Yes/No (If yes then fill following address fields) Enter the Address
State City Pin code Select the State Select city. If city is not found then select Other option. And give city name in the field provided for the. Enter the valid 6 digit pin code Details of PhD Institute Head Name of Head of PHD Institute* PhD Institute Head Designation* PhD Institute Head PhD Institute Head State* PhD Institute Head PhD Institute Head Pin code* Enter the name of Head Enter the Head Designation Enter the Address Select the State Select your city. If your city is not found then select Other option. And give your city name in the field provided for the. Enter the pin code Step 5 Academic Guide Details Details of the1st Supervisor/ Research guide for Phd Prefix* Full name* Mobile* Select name Prefix Enter the full name of 1 st supervisor Enter your 10 digit mobile No. (Don t append 0 or +91 before your No.).
Email* Bio data of PHD Supervisor* Enter the valid Email ID Attach the Bio data of PHD Supervisor Details of the 2 nd Supervisor/ Research guide for PhD Prefix* Full name* Select the name prefix of 2 nd supervisor Enter the name of 2 nd supervisor STEP 6 Partner company Details Details of Partner Company Name of Partner company* Partner Company website* Enter the name of partner company Enter the valid website URL (not including HTTP) Enter the Address State* Select the State Select your city. If your city is not found then select Other option. And give your city name in the field provided for the. Pin code* Annual Turnover of Partner Company* Enter the Pin code Enter the Annual Turnover of Partner Company.
Partner Company Logo* Partner Company Profile* Attach the Partner company Logo in JPG/PNG format Attach the Partner company profile in DOC format. Details of Partner Company Head Head of partner company* Designation of head of partner company* Address of Head of partner company* Enter the name of partner company head. Enter the Designation of head of partner company Enter the Address of Head of partner company State of Head of partner company* Select State of Head of partner company City of Head of partner company* Select City of Head of partner company Pin code of Head of partner company* Enter Pin code of Head of partner company STEP 7 Industry Mentor Details Prefix* Full Name* Mobile* Email* Select name Prefix Enter the full name of the Mentor Enter your 10 digit mobile No. (Don t append 0 or +91 before your No.). Enter the valid Email id of the Mentor Enter the address of the mentor
State* Pin code* STD Code* Phone No.* Upload Bio data of Industry Mentor* Select the Mentor the state Select your city. If your city is not found then select Other option. And give your city name in the field provided for the. Entre the valid 6 digit pin code Enter the valid STD Code Enter the valid Phone No. Attach the Bio data of Industry Mentor in Doc Format STEP 8 Current Employment/ Fellowship Details Currently availing any fellowship* Select Yes/No If Yes then fill the Following two details Name of the agency providing fellowship* Are you interested in switching over Present fellowship to the PM s Fellowship for the Doctoral Research* Enter the name of agency Select Yes/No Are You Currently employed in some job/assignment* Select Yes/No If Yes then fill the Following details Name of the Employer* Enter the name of Employer
Job assignment description/ designation* State* Pin code* Enter your job designation. E.g Quality Manager, Web Developer, Project Associate Enter the address Select the State Select your city. If your city is not found then select Other option. And give your city name in the field provided for the. Enter the valid 6 digit Pin code STEP 9 Undertaking & other Documents Undertaking from the Research Supervisor and Head of the Institute / University* Attach the Undertaking from the Research Supervisor and Head of the Organization of the Institute / University in doc Format. Undertaking from the Industry Partner in the Research Project* Letter from the Industry Partner (on company s letterhead) on the research problem and the future plans for implementation, if any Attach the Undertaking from the Industry Partner in the Research Project in doc format Attach the Letter from the Industry Partner (on company s letterhead) on the research problem and the future plans for implementation, if any in doc format (not compulsory) STEP 10 Declaration & Submit Declare that all the information given by is true to best of your knowledge and finally submit your application form.