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  Center of Excellence
  (Instruction manual attached at the last, Please refer it before filling the registration form)
1. Full Name :*
    Designation / Profile :*     Others please Specify :*
2. Highest Degree: *     Others please Specify :*
3. Persuing for a degree? *
    If Yes, What? :*     Where? University of :*
4. Working with : *
    Name of the Mentor :*     Affiliation of Mentor :*
    University of
    Address of Mentor :*     Pin Code :*
    State :*     Country :*
    Telephone Number :*     Mobile Number :*
    Fax Number :*
    E-mail :*     Website :*
    Address of Candidate :*     Pin Code :*
    State :*     Country :*
    Telephone Number :*     Mobile Number :*
    E-mail :*
    Area of interest :*     Subjects you teach :*
    Duration / Experience in years :*     Skill sets :*
       Total number of students you teach :*
    Semester I :*        Semester II :*
    Semester III :*        Semester IV :*
    Semester V :*        Semester VI :*
    How would you intend to
    contribute to Center of
    Excellence :*		        Who will be your contact
       person for this project:*
    Achivements :*        Documents published:*
    What kind of domain consultancy
    and team you have that can be
    used by other users? :*		        What are your university /
       Institute expectation from
       Center of Excellence: *


DECLARATION
  (To be signed by the applicant or its authorised agent)
       The particulars given are true and correct. No material has been suppressed.

       It is certified that I / We have read the guidlines, terms and conditions governiing the scheme and undertake to abide by them on behalf of

       my company / our organisation / institution. The financial assistance, if provided, shall br put to the declared use.

       All the IPR generated should be given back to the OSDD community. The materials involved in this process also belong to the / OSDD CSIR

       community.

      Center of Excellence Project Manager                                                                                                                   Male checked >        Female checked >
                                                                                                                                
                  Signature                                                                                                                                              Authorised Signatory for Company