Affapp 3

Visvevaraya Technological University, Jnana Sangama, Belgaum-590018
Application for Grant of New Research Centre / Continuation of Research Centre
Application for
Nature of Institution
Name of the Research centre
INSTITUTION DETAILS
Name of the Institution
Address of the Institution
Village/Town/City
District
State
Pin
STD Code
Land Line Number
PAN
Bank Account Number
Name & Address of the Bank
IFSC Code
Fax
E-mail Id
Year of Establishment
Affiliation to
Web site
Type of Institution
Minority Institute
Type of Minority
Name of the Minority
Women Institute
2. DETAILS OF PARENT ORGANIZATION

Name of the Society/ Trust
Address
Village/Town/City
District
State
Pin
STD Code
Land Line Number
Fax
Web site
Type of organization
Registration date
Name of the Chairman
Address
Village/Town/City
District
State
Pin
STD Code
Land Line Number
Mobile Number
E-mail Id
Fax
3. DETAILS OF GOVERNING COUNCIL (Annexure-1)
4. List of Other Institutions managed by the Society (Annexure-2)
5. DETAILS OF HEAD OF THE INSTITUTION

Name
Father's Name
Date of birth
Address
Village/Town/City
District
PIN
STD Code
Landline Number
Fax
Mobile Number
E-mail Id
Doctorate degree
Specialization
University
Master's degree
Branch
Specialization
University
Bachelor's degree
Branch
Specialization
University
Other qualifications
Date of joining the Institute as Principal
Appointment type
Experience
Total
Teaching
Research
Industary
No. of Books published as single author/co-author or as

editor
No. of Published Papers in National Level Journals
No. of Published Papers in International Level Journals
No. of Articles/Chapters published in Books
No. of Full Papers in Conference Proceedings
Ongoing Projects/Consultancies
Brief details
Completed Projects/Consultancies
Brief details
No. of Research Guidance

No.
of Research
Guiding Evaluation Technology
Training
Course,candidates
Teaching-Learning
Programmes, Faculty Development Programmes
Attended(not less than one week duration)
No. of Papers presented in
Conferences/Seminars/Workshops/Symposia
Invited Lectures delivered and Chairmanships at
International/National/Regional/Local conference/seminar,
etc.
6. PROGRAMME & COURSE DETAILS IN THE INSTITUTION (Annexure-3)
7. LABORATORY DETAILS
(Annexure-4) (FOR THE DEPARTMENT WHERE THE RECOGNITION SOUG
LIBRARY FACILITIES
Titles
Volumes
International
Journals
National
Journals
E-Journals
Member of Econsortium
Working Hours
Area (in Sqm)
Reading Room
Capacity
(in
Numbers)
Reprographic
Facility
Library Networking
No. of Multimedia
PCs
Library
Management
Software
Bar Code or RF Tab

book handling
Number of
Printers
No.of Legal
System
Softwares
COMPUTATIONAL FACILITIES
Number of PCs
for Students
Number of PCs
for Faculty
Name of the
service provider
Number of
PCsConnected to
LAN
Number of PCs in
Number of PCs in
Administrative
language Lab
Office
Internet
Contention
Ratio
Wi-Fi Facility
Total No.of PCs

available in the
College
Expenditure incurred in the Last 5 years towards Library, Equipment and Furniture
Y- Current year
Expenditure Am
2011
2012
2013
2014
Library
Equipment
Furniture
TOTAL
FACULTY DETAILS
(DETAILS REQUIRED FOR THE DEPARTMENT WHERE RECOGNITION SOUGHT)
(Annexure-4)
DETAILS OF TECHNICAL STAFF
(DETAILS REQUIRED FOR THE DEPARTMENT WHERE RECOGNITION SOUGHT)
13. SUMMARY
No.of Professors with Ph.D.
No.of Associate. Professors with Ph.D.
No.of Associate. Professors without Ph.D.
Total No.of faculty with Ph.D
No.of Faculty without Ph.D. with Patents, Extraordinary
Research work
Nature of R / D activities
No.of PG Courses offered in the department
14. GENERAL
UG
From
Working Hours of 1st shift
the institute
2nd Shift
PG
To
From
To
(An
Part time
No. of working days per week
15. DETAILS OF RESEARCH ACTIVITY (Annexure-7)
DETAILS OF RESEARCH SCHOLARS (Annexure-8)
DECLARATION
1
We give an undertaking to the effect that, we shall abide by all the conditions stipulated hitherto and those to be stipulated from time
We shall inform the University forthwith if there is any changes in

i). The staff strength
ii). Amount of funding to the department
iii). Change in the funding agency
On behalf of the College / Research Organization, we state that facts and information provided above are true to the best of our know
Chairman
Principal / Director
m-590018
arch Centre
niversity
niversity
niversity
NITION SOUGHT)
Investment till
the Date (in
Lakhs)
Budget for
current Year (in
Lakhs)
Type of Access
Library
Networking
Y
No.of Legal
Application
Softwares
Internet
Bandwidth
in Mbps)
penditure Amount (in Lakhs)

2015
Annexure-4)
GHT)
(Annexure-4)
ated from time to time by the VTU, Belgaum.
st of our knowledge.
pal / Director
No. of Multimedia
PCs
Type of Access
Open
Closed
Library Management Software

Y
Bar Code or RF Tab book handling

Y
Page No: 12 (a)
Page No:35 (a)
Title
Name
Father's Name
Designation
GOVERNING COUNCIL MEMBERS (Annexu

Qualification
Profession
Address
UNCIL MEMBERS (Annexure-1)

Address
Village/City
Tq
District
State
PIN
Contact Number
E-Mail Id
Sl.No.
Name
List of Other Institutions manag

Address of Institution
f Other Institutions managed by the Trust/Society (Annexure-2)

Type of Programme offered
Affiliating / Recognition Authority/Apex Body
Type of Land/Building
Area
Survey No
Level
Course
FT/ PT
Shift
PROGRAMME & COURSE

Entry
Year of Starting
PROGRAMME & COURSE DETAILS (Annexure-3)

Course Duration
Current Intake
ure-3)
Number of Students Admitted
Proposed Intake
Applied for
Accreditation status
Validity of Accreditation
From
To
LABORATORY
Programme
Level
LABORATORY DETAILS
Course
(Annexure-4)
Name of the LAB
Add seperatetely for each
exure-4)
Add seperatetely for each Course(Department) & Level wise

Equipments in the LAB as per Scheme and Syllabus
ment) & Level wise

No.of PCs available
Amount spent till date (in

Lakhs)
First Aid Facility
Title
Name
Name
Father's Name
Father's Name
Date of birth
Address
FACULTY DETAILS (Annexure-5) Copy th

Gender
Religion
ULTY DETAILS (Annexure-5) Copy the Sheet for each Department

Caste
Category
h Department
Date of Appointment
Designation
Date of Joining the

Institution
Department
Appointment type
Doctorate degree
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Doctorate degree
Specialization (type here)
University (type here)
Master's degree
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Bachelor's degree
Any other
Experienc
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Experience
Research (type here)
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single author/co-author or as
editor
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No. Published Papers in

National Level Journals
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published in Books
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Conference Proceedings
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Guiding
Training Course, TeachingLearning Evaluation

Technology Programmes,
Faculty Development
Programmes
Attended(not less than one
week duration)
Papers presented in
Conferences/Seminars/Work
shops/Symposia
Invited Lectures delivered and

Chairmanships at
International/National/Regio
nal/Local
conference/seminar, etc.
PF Number
PAN
Pay Scale
Basic Pay (in Rs)
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Bank Name
Bank Branch Name
IFSC Code
First Year Teacher
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STAFF DETAILS (Annexure

Title
Name
STAFF DETAILS (Annexure-6) Copy the Sheet for each Department

Name
Father's Name
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Training Course, TeachingLearning Evaluation

Technology Programmes,
Faculty Development
Programmes
Attended(not less than one
week duration)
PF Number
PAN
Pay Scale
Basic Pay (in Rs)
Gross Salary (in Rs)
Mode of Salary
Bank A/C Number
Bank Name
Bank Branch Name
IFSC Code










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Additional Assignment
Awards
e-mail
Mobile Number
Nature
Name of the Researcher
(i)
Research Guide
Nature
(ii)
Research scholar
Title of the Research work
Year of commencement of
Research work
(i)
Sl. No.
Details of paper published in connection with the

(ii)
(iii)
Type
Title of paper
National /International
paper published in connection with the Research title

(iv)
(v)
Citation
Abstract
Annexure
(vi)
(vii)
Name/s of co-author ( if any)
Upload PDF of the full length

paper.
Annexure-7
Details of paper p
(i)
(ii)
Sl. No.
Title of the paper
Details of paper presented

(iii)
(iv)
Type of conference
Date of conference
National / International
(v)
(vi)
Venue
Awards if any
Details of the Grant received

(i)
(ii)
Granting Agency
Year of sanction
received
(iii)
Amount
Details of patents
Recognitions/ awards
Status of the
Research work
Usefulness of the Research

work towards the society
Remarks
Sl.No
Name of the Research Scholar
of the Research Scholar
Year of Registration
Registered for
Name of the Research Guide
e of the Research Guide
Status
Course work Completion
Status
Comprehensive Viva-Voce
Submitted Final Thesis

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Visvevaraya Technological University, Jnana Sangama, Belgaum-590018

Application for Grant of New Research Centre / Continuation of Research Centre

2. DETAILS OF PARENT ORGANIZATION

3. DETAILS OF GOVERNING COUNCIL (Annexure-1)

4. List of Other Institutions managed by the Society (Annexure-2)

5. DETAILS OF HEAD OF THE INSTITUTION

No. of Books published as single author/co-author or as

No. of Research Guidance

6. PROGRAMME & COURSE DETAILS IN THE INSTITUTION (Annexure-3)

(Annexure-4) (FOR THE DEPARTMENT WHERE THE RECOGNITION SOUG

Area (in Sqm)

Bar Code or RF Tab

Total No.of PCs

(DETAILS REQUIRED FOR THE DEPARTMENT WHERE RECOGNITION SOUGHT)

DETAILS OF TECHNICAL STAFF

(DETAILS REQUIRED FOR THE DEPARTMENT WHERE RECOGNITION SOUGHT)

15. DETAILS OF RESEARCH ACTIVITY (Annexure-7)

DETAILS OF RESEARCH SCHOLARS (Annexure-8)

We shall inform the University forthwith if there is any changes in

penditure Amount (in Lakhs)

ated from time to time by the VTU, Belgaum.

Library Management Software

Bar Code or RF Tab book handling

Page No: 12 (a)

Page No:35 (a)

GOVERNING COUNCIL MEMBERS (Annexu

UNCIL MEMBERS (Annexure-1)

List of Other Institutions manag

f Other Institutions managed by the Trust/Society (Annexure-2)

Type of Programme offered

Affiliating / Recognition Authority/Apex Body

PROGRAMME & COURSE

PROGRAMME & COURSE DETAILS (Annexure-3)

Number of Students Admitted

Name of the LAB

Add seperatetely for each

Add seperatetely for each Course(Department) & Level wise

ment) & Level wise

Amount spent till date (in

First Aid Facility

FACULTY DETAILS (Annexure-5) Copy th

ULTY DETAILS (Annexure-5) Copy the Sheet for each Department

Date of Joining the

Branch (type here)

Branch (type here)

Branch (type here)

Branch (type here)

Branch (type here)

Branch (type here)

Branch (type here)

Branch (type here)

Branch (type here)

Branch (type here)

Specialization (type here)

University (type here)

Specialization (type here)

University (type here)

Specialization (type here)

University (type here)

Specialization (type here)

University (type here)

Specialization (type here)

University (type here)