Sample Application Form
(May be used for preparing the information before filling the Online Application)
                    COLLABORATIVE RESEARCH SCHEME (CRS)
                                  Under TEQIP
                          Proforma Cum Evaluation Sheet
1.1                                          Institute Details
(a)       Institute AICTE Permanent ID No.
(b)               Name of the Institute
(c)                Type of the Institute
(d)      Contact details/Address of Institution
(e)                       Email
(f)                       FAX
(g)                    Telephone
(h)                    PAN detail
1.2   Bank Details
(a)   Name of the Bank
(b)   Branch Name
(c)   Bank Branch Address (With PIN)
(d)   Name of the Account Holder
(e)   Type of the Account                                    Current Account         Saving Account
(f)   Account Number
(g)   Confirm Account Number
(h)   IFSC Code
(i)   Confirm IFSC Code
(j)   Bank MICR Code
1.3   Details of the Principal Investigator (PI)
(a)   TEQIP Faculty ID
(b)   Name of the PI
(c)   Department
(d)     Appointment Type                   Regular            Temporary         Adhoc
(e)     Contact details                    Address            Cell no           Email
(f)     Whether any other ongoing          Yes/No             Project Details (if any)
        Sponsored project by the PI
1.3.1   Details of the Collaborative - Principal Investigator 1 (Co – PI 1)
One preferably a regular faculty of Host TEQIP institute to which the PI belongs shall be Co-
PI-1
(a)     TEQIP/AICTE Faculty ID
(b)     Name of the Co-PI
(c)     Name of the Institution
(d)     Department /Industry Sector
(e)     Appointment Type                      Regular         Temporary             Adhoc
(f)     Contact Details                       Address         Cell no
 (g)     PG                                  Yes/No                 Area of specialization
 (h)     Ph. D                               Yes/No                 Area of specialization
(i)      Teaching Experience in years
(j)     Research & Industrial
        Experience in years
 (k)     Number of Publications               National Journal      International Journal
        in last 3 years (National /
        International journals)
 (l)    Number of Patents Registered
 (m)    Number of Ph D students Guided
1.3.2   Details of the Collaborative - Principal Investigator CO-PI (2,3,4)
CO – PI 2 from any TEQIP Institute/IIT/NIT
CO – PI 3,4 from any TEQIP Institute/IIT/NIT/Industry/Abroad Faculty
(a)     TEQIP/AICTE Faculty ID
(b)     Name of the Co-PI
(c)   Name of the Institution/ Organization
(d)   Department /Industry Sector
(e)   Appointment Type                        Regular         Temporary       Adhoc
(f)   Contact Details                         Address         Cell no         Email
(g)   PG                                      Yes/No               Area of specialization
(h)   Ph. D                                   Yes/No               Area of specialization
(i)   Teaching Experience in years
(j)   Research & Industrial
      Experience in years
(k)   Number of Publications                  National Journal      International Journal
      in last 3 years (National /
      International journals)
(l)   Number of Patents Registered
(m)   Number of Ph D students Guided
1.4   Details of the CRS Proposal
(a)   Title of the Project proposal
(b)   Area of the Proposal                              1.Energy
                                                        2. Environment
                                                        3.Climate Change & Sustainable Habitat
                                                        4.Healthcare
                                                        5.Information & Communication
                                                        Technology
                                                        6.Materials (Advanced)
                                                        7.Nanatechnology Hardware
                                                        8.Manufacturing
                                                        9.Security and defense
                                                        10.Water Resources
(c)   Name of the Lab where the research would be
      conducted
(d)   The Department under which the lab is
      established
1.5   Academic credentials of Principal Investigator (PI)
      Parameter/ Criteria              Input by    Input by Max.   Marks       Marks
                                       Institute   Institute Marks Awarded by Awarded by
                                                                   the System the Experts
(a)   Ph. D                            Select                 10
                                       Yes/No
(b)   Teaching Experience in           Enter                  2
      years                            Years
(c)   Research & Industrial            Enter                  2
      Experience in years              Years
(d)   Number of Publications           Enter                  4
      in last 3 years (National        Number
      journals)
(e)   Number of Publications           Enter                  2
      in last 3 years (International   Number
      journals)
(f)   Number of Patents                Enter                  5
      Registered                       Number
(g)   Membership of the                Select                 5
      Professional / Learned           Yes/No
      bodies/ Societies
(h)   Awards (State)                   Select                 2
                                       Yes/No
(i)   Awards (National)                Select                 2
                                       Yes/No
(j)   Awards (International)            Select                1
                                        Yes/No
                                       Sub Total             35
1.6    Credentials of Institute
      Parameter/ Criteria                 Input by    Input by Max.   Marks         Marks
                                          Institute   Institute Marks Awarded by   Awarded
                                                                      the System   by the
                                                                                   Experts
(a)   Research projects completed in       Enter                  5
       last 5 years                        Number
(b)   Consultancy Research projects        Enter                  5
       completed in last 5 yrs             Number
(c)   Number of Courses Accredited in      Enter                  5
       the Institutes                      Number
  (d)    Whether the UG/PG course under       Enter                           5
          which the proposal is submitted, is Yes/No
          accredited by NBA?
                                             Sub Total                    20
1.7      Justification of the project:
 (a)     Facilities/ equipment available in the Department in the area of proposed research
         S.No.       Name of equipment        Make and model        Cost in Rs.     Year purchased
         Parameter / Criteria                            Input by Institute       Max.     Marks
                                                                                  Marks    Awarded by
(a)      Objectives and Relevance of the Research                                   10     Experts
         project
(b)      Research status of the Proposal                 National International
         (National or International)                                                 -
(c)      Expected outcome                                                            5
(d)      Research Methodology                                                       10
(e)      Technical novelty and utility                                              10
(f)      Possible patentability of the research                                     10
         outcome
         Sub Total                                                                  45
         Grand Total                                                                100
 1.8 Non-Recurring Budget
 (a)    S.No. Proposed    Specifications Number Estimated Experts Recommendation
              equipment/s                of units Cost in (If proposal is recommended )
                                                  Rs.     Yes/ No      Number Amount
                                                                       of Units in Rs.
                 Total(NON RECURRING) Budget                              Total amount         Rs.ABC
                 Estimate
                                                                          recommended by
                                                                          experts
       1.9          Recurring     Budget
(a)
                                                                        Experts Recommendation
                                                          Estimated
       S.No.        Components      Specifications
                                                          Cost In Rs.                             Amount
                                                                        Yes/ No
                                                                                                 in Rs.
                    Domestic
       1
                    Travel
       2            Consumables
       3            Contingencies
       4            Miscellaneous
                    Total ( RECURRING) Budget                           Total amount
                    Estimate                                                                   Rs.PQR
                                                                        recommended by experts
1.10                Total Recommended Amount = Rs.ABC + Rs.PQR
11           Attachments (In PDF format)
(a)          Mandate Form
(b)          Certificate by the Head of Institution for the proposal.
(c)          Brief of Research Proposal containing project activities, schedule/timeline, relevance of
             Collaboration, industrial & social outcomes etc. (not more than 500 words)
(d)          Equipment List
(e)          Bio Data of Co-PIs (1,2,3,4)
           All India Council for Technical Education
                        Nelson Mandela Marg,Vasant Kunj, New Delhi-110070
         Mandate Form for Institute/College/University/Other Organizations
1        Name of the Beneficiary Institute
2        Permanent ID of the Institute, if any
3        Head of the Institute (Tick One)                   Director /Registrar / Principal / Others (Pl.
                                                            Specify
4        Type of Institute (Tick One)                       Govt. / Govt. aided/ Self Finance / Private etc.
5        Address of the Institute
6        PAN. No. of the Institute
 7       GST No. of the Institute
 8       E-mail ID of the Head of the Institute
 9       Name of the Bank
10       Branch Name and Branch Code
11       Address of the Bank with PIN Code
12       Telephone No. of the Bank
13       Name of the Account Holder with Designation
14       Account Type (Tick One)                            Savings / Current
15       Account Number
16       Bank Branch IFSC Code
17       Bank Branch MICR Code
18       Whether the Account is in the Name of              Yes /No
         Beneficiary Institute (Tick One)
19       Whether the Account is Operational (Tick           Yes/ No
         One)
20       Whether the account is a No-Frill                  Yes /No
         Account(Tick One)
21       Whether the Account is Joint Account(if yes        Yes/ No
         give details)
     It is declared that all information provided above are true and complete in all respects.
      Signature of the Account Holder                        Certified that the above details are verified on
      with Designation                                       (date)………………………………………….
      Or Authorized Signatory                                (Banker’s Signature with Seal)
      With Institute Seal
     Date : _____________
      (This certificate should be printed on the official letterhead of the Host Institute)
Letter No. -                                                          Date- dd-mm-yyyy
                   Certificate of Collaboration
       A certificate of collaboration for the research <Name of the research> between the
Principal Investigator <Name of PI> of the Host institute/industry sector <Name of Institute>.
       We the following PIs wish to work on this project. We agree to work in harmony and
hereby understand that the project needs to be completed in the time-bound manner.
 01   Co- Principal Investigator-1     <Name of Co-PI-1>              <Name of the Institute>
 02   Co- Principal Investigator-2     <Name of Co-PI-2>              <Name of the Institute>
 03   Co- Principal Investigator-3     <Name of Co-PI-3>              <Name of the Institute>
 04   Co- Principal Investigator-4     <Name of Co-PI-4>              <Name of the Institute>
      Under the collaborative research scheme- TEQIP III for the proposal of the grant,
complying with the guidelines of AICTE and TEQIP.
                                                      Signature of Head of the Host Institute
                                                                     Host Institute Seal
                         Collaborative Research Scheme
                             Required Equipment List
     Name of the Host Institute:
S.No.   Proposed        Specifications   Number of        Cost of        Justification of the   Estimated
        equipment/s     equipment/s      units required   single unit    Equipment              Cost in
                                                                                                Rs.
1
2
10
                                                                        Signature of the Applicant
                      Bio Data of Co – Principal Investigator
1    Name
2    Date of birth
3    Mobile Number
4    E-mail Address
5    Postal Address
6    Whether the Co- PI is working in
     Institute/Industry
7    Institute / Industry Currently Working
8    Whether faculty working or             Working                  Superannuated
     superannuated (Tick One)
9    Name of the Stream/Department
10 Academic credentials                     PG Qualification
                                            (Degree)
                                            Ph.D. (Yes/No)
11 No. of Ph.Ds. Guided
12 Experience (Yrs.)                         Teaching     Research     Industrial      Total
13 Membership of Professional Bodies
14 Publications                                  Thesis/Book                Journals
15 Conferences/Seminars Attended
16 Patents (if any) (Nos.)
17 Other (awards if any)
18 Any other information
Declaration
I___________ hereby declare that the details provided above are true and best of my
knowledge.
                                                                     Signature of the Co-PI