ICAR-Indian Agricultural Research Institute
Prof. E. A. Siddiq Award in Genetics (Crop/Animals/Fish/Microbes) and Breeding
General Information for Official Use Only
Name of the Institute nominating the person:____________________________ _____________
Field/discipline___________________________________________________________________
1. NAME OF THE CANDIDATE : _____________ ____________ ______________
(First) (Middle) (Surname) 2. DESIGNATION:
3. ADDRESS:
4. CONTACTS: Office:
Tel.: Fax:
E-mail:
Res.:
Tel.: Fax:
E-Mail:
Mobile:
5. DATE OF BIRTH: __________ ___________ ___________
(Please provide the proof) (Day) (Month) (Year) Age as on 01.01.2020___________Year___________Month__________Day
6. (A) ACADEMIC QUALIFICATIONS
Degree/Diploma Year Major Field University/
Institution
Division/
Distinction Masters
Ph. D
Any other
degree/diploma
7. EMPLOYEMENT STATUS Designation Pay scale
(Rs.)
Nature of work Institute (Organization) Period (From- To)
8. RESEARCH ACHIEVEMENTS:
Significant contributions related to the relevant field of specialization for the award applied (patents, novel technologies, varieties/genetic stocks/breeds/concept/methodology etc.)
Title Details Year
9. (A) Best ten technologies/varieties/ breeds/stocks released or commercialized (during last 10 years) Technology/variety
with crop
Year Features Notified/recommended
etc.
9. (b) BEST TEN RESEARCH PUBLICATIONS (During last 10 years)
Authors Year Title Journal NAAS
Journal ID
NAAS Rating
9. (c) Total No. of Publications (Please enclose the list) Refereed
Research Papers**
Books* Book Chapters
Reviews** Technical
Bulletins/Reports
Popular Scientific articles
Manuals developed
Any other
*Authored/edited volume
** Only in international impact/NAAS rated above 6.0 jounal
10. AWARDS/RECOGNITIONS
Name of the Award/Recognition Year National/
International
International/Society/Professional
Please mention if this work has been recognized for any other award.
11. Any other information
(Signature of the applicant) Date:
“Certified that the information given by the candidate in this application has been verified and fully authenticated by the recommending authority and that there are no disciplinary action or proceedings pending or contemplated against the candidate..”
Recommendation of the Head of the Institution (Signature)
Seal
