Impress Event
Impress Event
Impress Event
Application Form
Paste Your
Broad Domain
Passport
Size
Photograph
Broad Sub-domain Here
PERSONAL INFORMATION
Mother’s Name
Permanent Address
GEN SC ST OBC
If yes ---
Designation: (Professor / Associate
Professor / Assistant Professor /
Others)
Employer’s details
Name:
Address:
Contact Number:
Email ID:
Website:
If No ----
Last Designation: (Professor /
Associate Professor / Assistant
Professor / Others)
Last Employer’s details
Name:
Address:
Contact Number:
Email ID:
Website:
Affiliation Details
Name & Address of the affiliating
institution
(website including phone number,
email ID)
Type of affiliating institution Institute of National Importance
Central University
State University
Govt. funded Institutions
ICSSR Research Institute
Private Institutions with UGC 12(b) status
Whether received any financial assistance from ICSSR (latest 2 in case of yes)
Yes/No _____________________________________
Year of Award _____________________________________
Amount sanctioned _____________________________________
Date of Completion, if completed _____________________________________
If incomplete, proposed date of completion _____________________________________
Whether received any financial assistance from any other national/international institution
(latest 2 in case of yes)
Yes/No _____________________________________
Year of Award _____________________________________
Amount sanctioned _____________________________________
Date of Completion, if completed _____________________________________
If incomplete, proposed date of completion _____________________________________
Total Grant expected under the
scheme (In Rs.)
Duration Proposed
Declaration
I hereby declare that:
1. I am not a defaulter of any previous grant from any of the MHRD funded Institutions.
2. I have neither been subjected to any disciplinary action nor found guilty of any offence in
my career.
3. The Research Proposal and its contents are entirely original (not plagiarized) and as per
the standard practice.
4. I have not concealed any information in my application. If ICSSR finds any contrary
information at any stage, it may cancel my project at any stage.
Place:
Date:
Signature of the Applicant
DOCUMENTS TO UPLOAD
1. Brief academic CV (not more than 2-3 pages.
2. Self-attested SC/ST and disability certificate issued by the competent
authority.
Indian Council Of Social Ministry of Human Resource
Science Research (ICSSR) Development, Government of
India
Broad Domain
Broad Sub-domain
How will the Seminar / Conference / Workshop benefit the policy making in the mentioned
domain and sub-domain area? (Max. 150 words)
Proposed Date, Duration and
Venue
Publication Plan
□ Publication of proceeding (Date of Release)
____________________________________________________________________
□ Publication of Book (Edited) with possible list of papers
______________________________________________________________________
______________________________________________________________________ +
Place:
Date:
Signature of the Convener
DOCUMENTS TO UPLOAD
1. Forwarding letter from the Head of the affiliating Institution duly stamped and
signed on the letter head.
UPLOAD DULY STAMPED AND SIGNED ON THE LETTER HEAD
The In-charge,
IMpactful Policy REsearch in Social Science (IMPRESS)
Indian Council of Social Science Research (ICSSR)
JNU Institutional Area
Aruna Asaf Ali Marg,
New Delhi - 110067
The_________________________________________________________________
(Name of the organization) forwards application of ___________________________
(Name of the Convener) for the financial assistance for organizing seminar / conference
/ workshop on the theme - ________________________________________________
_____________________________________________________________________
with an undertaking that this organization agrees to administer and manage the
IMPRESS Seminar Grant and provide basic infrastructural facilities for the above-
mentioned seminar /conference / workshop as per rules of the grant.
The institution shall be responsible for submitting the audited statement of accounts
and utilization certificate for the grant received by it for this purpose.
Place:
Name:_______________________
Date:
Designation:__________________