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Part

1:

Applicant's Basic information

1.

Applicant's

Name

^:

NST FELLOWSHIP APPLICATION FORM

^(MS/NISc)

INSTRUCTION: Please read these instructions carefully. You must fill ^{in all}of the entries. If you have no data of any entry, you may write'nd' (no data) there. Yau nwsl ttse TIMES NEW RAMAN ,j'ON'f, size '/1./itr capital letters tnd tii:;e

l2 for ^s*mll^{lett*s\^}

PP Size Photo

Iin

English]

:...

Iin

Bengali]

:...

2. Applicant'sMobileNumber

:...

3. Applicant'sE-rnailAddress

:...

4.

Applicant's

NID Number'

: ...

Part 2: Applicant's Current Stuclentship Information

(i)

StudentshipType(Full-Tirne/Part-Tirne/EveningCourse) :...

(ii)

^Nameof the University ^:

(iii)

Nalne of the

Faculty/School

:...

Part 3: Applicant's Schooling Record

[Minimurn Requirement: ^SSC:GPA 4.5, HSC: GPA 4.5, BSc/MBBS/BSc Errgineerirrg: CGPA 3.4]

Exarnination Name of the Institution Year

of

Passing

GPA/

CGPA

Department

SSC/Equivalent HSC/Equivalent BSc/Equivalent

11

*

(4)

NST Appllcatioi ionn

Part 4: Information Related to Research Proposal

L

Title of the Research:

[Attach ^researchproposal separately with this application for"rn (not mole than 3 pages. Timcs Neu,Roman lbnt sizc I t)l

2.

Write 02 (two) objectives of your research proposal

3.

Which of the follor.ving do your research r,vork based on? (please tick)

(i)

Only Lab Work

(ii)

Field

&

Lab Work

(iii)

Survey

&

Lab Work

(ir)

Survey. Field

&

^LabWork

(v)

Only Field Work

("i)

Only Survey Work

(vii)

Only Cornputer Work

(viii)

Survey

&

Cornputer Work

4.

Name, designation

&

address of your

supervisor

:...

a.

Mobile nnlnber of your

supervisor

:...

b.

^Email^addressof your

supervisor

:...

5.

^Name,designation

&

^addressof tlte head of your depaftment:...

a.

Mobile number of the head of your depaftment:

b.

^E-rnail^addressof the head of your depaftment:

Part 5: Applicant's Swear

1.

I myself have filled in this NST application form,

2.

^I^amreconflrrning the following information- My rnobile nurnber:

My NID

number

^: My e-rnail address :

(5)

NST Application form

3.

luibrnration Ihave given in this firrm is correct and authentic.

4.

Countersign by the head of the department:

(SignatLrre of the Applicant) Date .

(S,Cr^trrrd Of-fi.l S."l .f'

Depaftment) Date .

(6)

NST FELLOWSHIP APPLICATION FORM (MPhil

^and

^PhD)

INSTRUCTION: Please read these instructions carefully. You must fill in all of the entries. If you have no data of any entry, you may write 'nd' (no data) there. You must use TIMES NEW ROMAN FONT, size 11 far capital letters and ^size¹²for smull letters).

PP Size Photo

Part

1:

Applicant's Basic

Information

l.

Applicant's Name ^:

[in

English]

:... ... ... ...

[in ^Bengali]

2.

^Sex

3.

^Father's^Narne^:...^....

1.

Mother's Name :

...

5.

^Dateof

Birlh : DD MM YYYY

6.

Age (on date of

application): DD MM ^YYYY

7

. Nationality

:... ... .

B.

Horne

District

:... ...

.

^...

P art

2:

Athninistrative Communication

l. Applicant'sPresentAddress :...

2.

Applicant's Mobile

Number

:... ....

3.

Applicant's E-mail

Address

^:

(7)

Part 3: Applicant's Academic Information

[Minimum Requirerlent-SSC: GPA 4.5, HSC: GPA 4.5, BSc: CGPA 3.2, MS/MSc: CGPA 3.2]

Examination Name of the

School/College/

University

Year

of

Passing

Division iClass

GPA/CGPA Department

SSC/Equivalent HSC/Equivalent BSc/Equivalent MS/MSc

Part 4: Applicant's Current Studentship Information

(i)

Narne of the

Universitr

:... ....

(ii)

^Nameof the Faculty/School :... ....

(iii)

Narne of the

Departtnent

:... ....

(iv)

Admission Date of MPhil/PhD

Course

^:

(v)

^Whetheryour admission is confirmed by the acadernic council /proper authority (please rvrite yes or no. If yes, attaclr the proof)

(ui)

Academic year now _.voubelong to (1'r

i

2"d

l3't)

:... ... .

(vii)

Studentship Type (please tick one)

(a)

Full-Tirne Student

(b)

Part-Time Student

(c)

Evening Course Student

Part 5: Type of NST fellorvship you are applying for (please tick one)

(i) l"

year MPhil/PhD ^(asa nen applicant)

(ii)

2,d year MPliil/PhD (as a ne*, applicant)

(iii)

3"ryear PhD (as a new applicant)

(iv)

^2nd^yearMPhil/PhD (as a rener,val applicant)

(u)

3'd year PhD (as a rerrerval applicant)

(vi)

Group you applied for (AgricultLrre /Biology/ Physical science):...

P:rrt 6: Applicant's Record of Academic Feats

(i)

Do you have any published article in peer review joumal? . . .

(ii) If

yes, horv many publication?

Part 7: Information Related to Research Proposal

1.

Title of the Research:

[Attach ^research^proposal

(if

you are in 1" year) separately with this application fbrm (nor more rharr 0-]

pages. Times Neu" Roman fbnt size I l)'l

2.

_[Attach^research^progressrepofi

(if

you are in 2''d /3"ryear /reneu'al) separately with this application fbrm ^(notr.nore than ()il pages, l'inres Nex,Roman fbnt size I

l)l

(8)

3.

Write 02 (trvo) ob-lectives of )'our ^researcl.r

(i) .

^.

(ii).

Which of the following do your research work be based on? (please tick one or more)

(i)

Only Lab Work

(ii)

Field

&

Lab Work

(iii)

Survey

&

Lab Work

(iv)

Survey, Field

&

Lab Work

(v)

Only Field Work

(ui)

Only Survey Work

(vii)

Only Computer Work

(viii)

Survey

&

Cornputer Work

4.

Location of your research

work

^:

5.

^Narne,designation

&

address of your

supervisor

^:

a.

Mobile nurnber of yor-rr

supen'isor

ⁱ

b.

^E-rnail^addressof your

supervisor

^'.

a.

Mobile number of the head of your

department

^:

Part 8:

Impact

area of your research

work

(a)

Write name of industries /area of knowledge your ^researchresult

will

impact on (i)

( ii)

Part 9: Applicant's Financial Assistance Record

1.

Did you get NST fellowship

at

MS/I\4So /IvI Phil level?

2.

Are you presently enjoying any other financial support?

Part 10: Applicant's Job Related

Information

1.

Are you engaged in any salaried job?

(a)

Ifyes,

(i)

Write the name, address, phone, e-mail of the

organization

^:

(ii)

Do you have leave order frorn appropriate authority'/ ...

(b) Ifyou

^arenot injob, briefly describe your current

occupation

^:

(StudenVPrivate BusinessA{ousewife/Freelancer etc)

Part 11: Applicant's Declaration

I

.

I myself have fllled in this NST application form

2. lf I

leave /stop rny research w'ork (whatever is the reason), as soou as possible, I

will

inform it to the Mirristry of Scier-rce

&

Technology.

3.

I

will

not receive any other fellorvship along with NST fellowship.

.'-->J-:- ^-/=---=

\./

(9)

4.

I am reconfirming the following information- My urobile nunrber My NID number My e-rnail address

5.

Information I have given irT the forn-r is correct and genuine.

6.

Countersign by the head of the department:

Signature of the Applicant Date

(Signature and Official Seal of the Heacl of the Department)

Date ..

+ n

(10)

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