Government of West Bengal Department of Higher Education, Science & Technology and Biotechnology (DHESTBT)

Similar documents
Department of Science & Technology Terms & Conditions of the Grant

Guidelines for implementing Research Projects SCIENCE AND ENGINEERING RESEARCH COUNCIL

Technology Business Incubator (TBI)

NATIONAL RESEARCH DEVELOPMENT CORPORATION TECHNO-COMMERCIAL SUPPORT FOR PROMISING INVENTIONS / INNOVATIONS GUIDELINES

APPLICATION PROFORMA FOR SUPPORT TO SYMPOSIUM/ SEMINAR/ CONFERENCE /WORKSHOP (APPLICATION TO BE TYPED IN ARIAL FONT - 12 SIZE )

Appendix 1. (Please read carefully the guidelines to investigators before filling this proforma)

SCIENCE & TECHNOLOGY ENTREPRENEURSHIP DEVELOPMENT (STED) PROJECT

PROFORMA FOR SUBMISSION OF PROPOSAL (For F.Y: )

GUIDELINES FOR ORGANISING CONFERENCE / SEMINAR/ WORKSHOP/ FDP/ STTP BY AFFILIATED COLLEGES IN COLLBOARTION WITH GUJARAT TECHNOLOGICAL UNIVERSITY

APPLICATION FORM FOR PERMISSION FOR SETTING UP COMMUNITY RADIO STATION (Seven Copies to be submitted)

Name and Address of the Institute/organisation where the project will be implemented.

Advertisement No.1/2017/Bio-incubator RECRUITMENT FOR ADMINISTRATIVE AND TECHNICAL POSITIONS FOR BIO-INCUBATOR

INDIAN COUNCIL OF PHILOSOPHICAL RESEARCH Darshan Bhawan, 36, Tughlakabad Institutional Area M.B Road, New Delhi

Recruitment of Executive Director (Finance) in BSNL through immediate absorption basis

[***Kind Attention: Grantees of Repertory Grant-Instructions regarding submission of Utilization Certificate in revised format of GFR 12-A***]

ANNEXURE-III (TO BE POSTED ON BANK S WEBSITE) (A Society/Trust Sponsored by Central Bank of India) Year

Guidelines for Joining ICMR -JRF

APPLICATION FORM FOR GRANT OF PERMISSION FOR SETTING UP COMMUNITY RADIO STATION (FM) (To be submitted in Quadruplicate)

Recruitment of Executive Directors (C&M/CN/AB) in BSNL through immediate absorption basis.

National Institute of Technology Silchar

MATCHING SCHEME OF ASSISTANCE TO PUBLIC LIBRARIES TOWARDS INCREASING ACCOMMODATION

F.No.22032/03/2007 -N GO(VoI.III) Government of India

(APPLICATION FORM FOR SCIENTIFIC POSTS) Affix No columns should be left blank.

NON-MATCHING SCHEME OF FINANCIAL ASSISTANCE TO DEVELOP DIFFERENT SECTIONS OF GENERAL PUBLIC LIBRARIES TITLE AND OBJECT 1. The scheme is known as

Sr. Post /Discipline Pay Scale Qualifications

APPLICATION PROFORMA FOR SUPPORT TO SYMPOSIUM/ SEMINAR/ CONFERENCE /WORKSHOP (APPLICATION TO BE TYPED IN ARIAL FONT - 12 SIZE )

ANNEXURE-III (TO BE POSTED ON BANK S WEBSITE)

DIRECTORATE OF HEALTH SERVICES JAMMU

Annexure-II. Regional Office: Motihari (Specimen for window advertisement)

NATIONAL ZOOLOGICAL PARK MATHURA ROAD, NEW DELHI

ANNEXURE-III (TO BE POSTED ON BANK S WEBSITE) (CBI-SUAPS) (A Society/Trust Sponsored by Central Bank of India)

NHPC FELLOWSHIP SCHEME FOR ASSAM 2016

VOCATIONAL TRAINING IN TRIBAL AREAS (w.e.f )

NATIONAL ZOOLOGICAL PARK MATHURA ROAD, NEW DELHI

ADMISSION NOTICE Diploma in Health Promotion Education (DHPE) Post Graduate Diploma in Community Health Care (PGDCHC)

The Institution of Engineers (India) Technical Department Technical Activities in collaboration with Engineering Institutes

BANARAS HINDU UNIVERSITY SCHOOL OF NURSING SIR SUNDERLAL HOSPITAL VARANASI

Sub: - Recruitment of Aircraft Technicians from the open market

Instructions for Institutes for claiming 2 nd Installment on AICTE portal under PMKVY-TI for the AY

GOVERNMENT OF KARNATAKA VISION GROUP ON SCIENCE AND TECHNOLOGY DEPARTMENT OF SCIENCE AND TECHNOLOGY

APPLICATION FORM FOR ENLISTMENT OF VENDORS

MIT SCHOOL OF SUBSURFACE ENGINEERING

(APPLICATION FORM FOR SCIENTIFIC POSTS) Affix No column(s) should be left blank. Note: All answers must be given in words and not by dashes and dots.

SCHEME OF GRANT-IN-AID FOR PROMOTION OF AYUSH INTERVENTION IN PUBLIC HEALTH INITIATIVES.

INDIAN NATIONAL SCIENCE ACADEMY

STATE BANK OF INDIA PREMISES & ESTATE DEPARTMENT 3 RD FLOOR, LOCAL HEAD OFFICE BHADRA, AHMEDABAD PH : (079)

of Executive Directors (C&M/CN/AB) in 'BSNLthrough immediate absorption basis.

Madhya Pradesh Biotechnology Council

Dr. Ambedkar Medical Aid Scheme (Revised 2016)

JAWAHARLAL NEHRU UNIVERSITY NEW DELHI

GOVERNMENT OF INDIA MINISTRY OF LABOUR AND EMPLOYMENT

University of Mumbai

PROFORMA FOR SUBMISSION OF PROJECTS UNDER BIOTECHNOLOGY- BASED PROGRAMMES FOR RURAL DEVELOPMENT

Pl.B/Circular/Seminars State Plan Funds/ CIRCULAR

ENLISTMENT OF CONTRACTORS FOR CIVIL, ELECTRICAL AND INTERIOR WORKS

STATE BANK OF INDIA EMPANELMENT OF AUDITORS FIRE SAFETY AUDITOR ELECTRICAL SAFETY AUDITOR TABLE OF CONTENTS: IMPORTANT DATES:

GUIDELINES FOR SANCTION OF FINANCIAL ASSISTANCE FOR CONTINUING NURSING EDUCATION (CNE)

No. 32-1(3)/2016-Rectt. BHARATSANCHARNIGAMLIMITED Corporate Office (Recmitment Section)

West Bengal State University

Ref : ACASH/Exhb/ / Date :

SCHEME FOR INFRASTRUCTURE DEVELOPMENT PRIVATE AIDED/UNAIDED MINORITY INSTITUTES (IDMI) (ELEMENTARY SECONDARY/ SENIOR SECONDARY SCHOOLS)

EXPRESSION OF INTEREST IN APPOINTING A PANEL OF ATTORNEYS

National Environment Awareness Campaign (NEAC) Programme

APPLICATION FORM (for Scientific and Technical Posts) Married. 5. Date of Birth: Place of Birth. 6. Age (as on ) Years Months Days.

HIGHER EDUCATION COMMISSION H-9, ISLAMABAD (PAKISTAN) APPLICATION FORM GRANT FOR ORGANIZING CONFERENCE/SEMINAR/SYMPOSIUM

S.No. Name of Post Number of Consolidated pay Duration of contract 1. Technician / Technician lab 01 (UR) Rs. 17,040/- per month Three months

PARLIAMENT OF INDIA (SPEAKER S RESEARCH INITIATIVE)

Central Council for Research in Yoga & Naturopathy Janakpuri, New Delhi

File No.APPCB/RFS/UH3/

INDO-ITALIAN EXECUTIVE PROGRAMME OF COOPERATION IN SCIENTIFIC & TECHNOLOGICAL COOPERATION. (Proforma for Application for Joint Research)

Government of India Ministry of Road Transport and Highways

Call For Indo-Japanese Joint Project on Establishment of Young Researcher Fellowship Programme

Indian Council of Medical Research Guidelines for Extramural Research Programme

A. SUPPORT FOR CONDUCTING SEMINAR / WORKSHOP /CONFERENCE

Vacancy Notice No. RCIL/2014/P&A/44/37 (ii) NER

INNOVATIVE YOUNG BIOTECHNOLOGIST AWARD (IYBA)

PROFORMA FOR SUBMISSION OF PROJECT PROPOSALS ON RESEARCH AND DEVELOPMENT, PROGRAMME SUPPORT (To be filled by the applicant)

Technology Business Incubator (TBI)

MODERNISATION AND REMOVAL OF OBSOLENSCENCE (MODROBS)

Recruitment Notification No. 01/2018. Name of Post Pay Scale/Grade No of Post

SCHEME OF PRE-MATRIC SCHOLARSHIP FOR STUDENTS (FIRST TO TENTH) BELONGING TO THE MINORITY COMMUNITIES FORMAT OF APPLICATION [ ]

Municipal Service Commission 149, A.J.C.Bose Road, Kolkata (Opposite R.Ahmed Dental College & Hospital near Maula Ali)

National Institute of Fashion Technology A Statutory Institute governed by the NIFT Act, 2006 Ministry of Textiles, Government of India

APPLICATION FOR THE POST OF DIRECTOR, IMU KOLKATA CAMPUS

SOLAR ENERGY CORPORATION OF INDIA LTD. (A

Product(s) Installed Capacity Existing Proposed Existing Proposed

N.B.: The written examinations against Advt No. 03/2017 and Advt No. 04/2017 will be held on different dates. Minimum Qualification

LETTER OF INVITATION FOR CAMPUS PLACEMENT PROGRAM

REQUEST FOR REGISTRATION AS SUPPLIER FOR THE PERIOD STARTING 1 ST JULY 2016 AND ENDING 30 TH JUNE 2018

ITEM RATE TENDER TENDER No. 14 / / ELDB

NCC Infrastructure Holdings Limited

Scholarship Scheme for Faculty Members from Academic Institutions

GUIDELINES FOR RESEARCH & DEVELOPMENT PROJECTS UNDER BIOINFORMATICS, COMPUTATIONAL AND SYSTEMS BIOLOGY

MANIPUR UNIVERSITY: CANCHIPUR (A Central University) Imphal , Manipur, India

Skill Development Training for Scheduled Caste

Advt. No.A.12025/2/2015-Admn.II NATIONAL INSTITUTE OF HEALTH AND FAMILY WELFARE Baba Gang Nath Marg, Munirka, New Delhi VACANCY NOTICE

Ref : ACASH/Exhb/ / Date :

INNOVATIVE YOUNG BIOTECHNOLOGIST AWARD (IYBA)

Subject: Appointment to the post of Mission Director of AUSC project on Contractual basis

REVISED SCHEME FOR EXTERNAL MARKET DEVELOPMENT ASSISTANCE

Transcription:

Government of West Bengal Department of Higher Education, Science & Technology and Biotechnology (DHESTBT) (Science & Technology and Biotechnology Branch) Vigyan Chetana Bhavan, Block-DD, Plot-26/B, Sector-I Salt Lake City, Kolkata-700064 General Guidelines, Terms & Conditions and Application Format for different types of Science Popularisation Programmes General Guidelines Department of Higher Education, Science & Technology and Biotechnology (Science & Technology and Biotechnology Branch) Government of West Bengal aims to support audio-visual and other communicative programs on relevant fields of Science & Technology and Biotechnology with a layman s perspective, through which more jargon and technology oriented Science and Technology can percolate down to the grassroots level, so as to create an impact among the public in West Bengal to be organized by Government/Aided/Private Schools, Colleges, Universities, Institutes, Registered Non-Government Organizations (NGO), Trustees etc. Financial assistance for the benefit of the faculties, research scholars, students, unemployed youths and common people related to Science & Technology (S&T) orientation and application in conformity with the socio-economic necessities of the state of West Bengal shall be given preference. The General Guidelines, Terms & Conditions and Application Format for different types of Science Popularisation Programmes are available from Departmental website: www.wbhed.gov.in or www.vigyanchetana.in. Along with the hard copy, one soft copy of the filled in Application Format along with the General Guidelines and Terms & Conditions duly signed with official stamp (in single PDF format only) must be submitted for seeking financial assistance from this Department. Filled in applications along with entire proposal to be submitted to: The Special Secretary to the Govt. of West Bengal Department of Higher Education, Science & Technology and Biotechnology (Science & Technology and Biotechnology Branch), Vigyan Chetana Bhavan (2nd Floor), DD-26/B, Sector- I Salt Lake, Kolkata-700064 E-mail: wbscipop@gmail.com Terminology used: DHESTBT PC NGO S&T SC/ST PCR UC SoE EAC TLM : Department of Higher Education, Science &Technology and Biotechnology : Program Co-ordinator : Non-Government Organisation : Science & Technology : Schedule Caste/ Schedule Tribe : Program Completion Report : Utilization Certificate : Statement of Expenditure : Entrepreneurship Awareness Camp : Teaching & Learning Materials and/or Methods 1

Terms & Conditions 1. The programme is constituted for the purpose of providing financial assistance in the form of grants for the Popularisation of Science in the State of West Bengal. Grants will be paid for specific activities/ task for specific target groups useful for the society. 2. The financial assistance may be provided for a maximum period of six months. Usually the sanction will be given for the full period. The financial assistance shall be utilized for the purpose for which it is granted within the specified period. The exact date of commencement should be intimated in writing to DHESTBT well in advance so that the Department may depute any official for attending the programme. 3. Generally this programme does not provide any financial assistance for development of infrastructure. However, with due permission from DHESTBT, if any assets are acquired/created from the received grant then those assets will be the sole property of DHESTBT and these should not be disposed off or encumbered or utilised for the purpose other than those for which the grant had been sanctioned, without the prior approval of the DHESTBT. At the termination of the programme, the DHESTBT has the discretion to gift the assets to the Institute/Organisation or transfer them to any other Institute/Organisation if it is considered appropriate. 4. The Head/ Program Co-ordinator (PC) of the Institute/Organisation shall furnish Progress Report of the activities immediately after successful completion of the programme. In addition, DHESTBT may designate Scientist/ Specialist or an Expert Panel to visit the Institute/ Organisation periodically to review the progress of the activities being carried out and to suggest suitable measures to ensure realisation of the objectives of the programmes. During the implementation of the program, the Institute/ Organisation will extend necessary hospitalities and logistics support to the visiting scientist/ specialist or the Expert Panel during the time of their visit. 5. On completion of the program, original signed and stamped five (5) copies of the Utilisation Certificate (UC) and Statement of Expenditure (SoE) audited by a Chartered Accountant should be submitted as per the format given. Beside this, one copy each of final consolidated Program Completion Report (PCR) including list of participants, list of resource persons/ dignitaries/ experts etc., photographs (both in hard and soft copies), videos and feedbacks of the participants on the work done (both hardcopy and softcopy) should be sent to DHESTBT. The Utilization Certificate (UC) & audited Statement of Expenditure (SoE) should be countersigned by the Program Co-ordinator (PC) Head of the Institute (HOI) within three months after completion of the Program. 2

6. No Institute/ Organization shall be allowed to apply for next financial assistance from DHESTBT unless and until they submit UC & audited SoE, Program Completion Report (PCR) including photographs, videos and feedbacks (both hardcopy and softcopy) of their previous grant. 7. At the end of the programme, the unutilised amount, if any shall be refunded to DHESTBT as per Govt rules. If for any reason, it is found that the recipient has not utilized the grant for the purpose for which it was sanctioned, the Program Co-ordinator (PC)/ Institute/ Organisation shall be disqualified for getting any further grants in near future and steps shall be taken against such PC/ Institute/ Organisation. 8. The Institute/Organisation will maintain separate audited accounts for the Programme. If it is found to keep a part or whole of the grant in a bank account to earn interest, the interest thus earned should be reflected in the UC/SoE and that should be used for the same program. 9. The Institute/Organisation will not entrust the implementation of the work, for which the grant is being sanctioned, to another Institution/Organisation nor will it divert the grant receipts to other Institute/Organisation as assistance. In case the Institute/Organisation is not in a position to implement or complete the program, it should, forthwith, refund the entire grant received from DHESTBT or the balance grant lying with them. 10. DHESTBT reserves the right to terminate the grant for the program at any stage if it is convinced that the grant has not been properly utilised or appropriate progress is being made. Also, the PC/HOI is liable to refund the grant amount in part or in full, in case of unsatisfactory implementation of the program or unwillingness to co-operate with DHESTBT for monitoring/evaluating the progress of the program. 11. The program becomes operative with effect from the date of receipt of Government Order (GO) or the date on which the fund is received by the implementing Institution/ Organisation, whichever is earlier. The programme date should be intimated by the Institution/Organisation/PC to DHESTBT in writing. 12. If the PC to whom a grant for a project has been sanctioned wishes to leave the Institution/Organisation where the project is being sanctioned by DHESTBT, the Institute/organisation/PC will inform the same to DHESTBT and in consultation with DHESTBT, evolve steps to ensure successful completion of the project, before relieving the PC. 13. Institute/organisation/PC willing to publish technical/ scientific papers based on the work done under the program should acknowledge the assistance received from DHESTBT. Name of the sponsoring authority, e.g., Sponsored by Department of Higher Education, Science & Technology and Biotechnology 3

(Science & Technology and Biotechnology Branch) Government of West Bengal must be properly printed/ published in the invitation cards/ brochure/ banners/ hoardings/ proceedings etc. 14. The knowledge generated from the program will be the property of DHESTBT and should be properly acknowledged always. Transfer of technology/ Intellectual Property Rights (IPR) issues generated shall be done in consultation with DHESTBT. 15. The Competent Authority of DHESTBT may enforce additional guidelines, terms & conditions for the successful operation of the programmes from time to time and the Institution/Organisation/PC are required to follow such directions to conduct the program. 16. Application will only be accepted in the latest prescribed format only. Application should be duly recommended by the Jt.BDO/ BDO/ SDO/ DM/ MLA/ MP/ Sabhadhipati etc. (for NGO/Trustee). Mere application in the prescribed format shall not entitle the applicant to any financial assistance from DHESTBT. Decision of the Competent Authority of DHESTBT on all matters shall be the final and no correspondence will be entertained in this matter. 4

17. Different type of Science Popularisation Programmes: Programme Duration Nos. of Participation Maximum Amount (Rs) Seminar/Workshop/Conference/Symposium/ Short Term Course etc. organised by 2 days 50 75,000 University/Research Institute/Autonomous Institute Seminar/Workshop/Conference/Symposium/ 2 days 50 50,000 Short Term Course etc. organised by Colleges Seminar/Workshop/Conference/Symposium etc. organised by School/ Trustee/ Registered NGO Science Camp with hands-on-experiment for School Students involving surrounding Schools organised by Institute/ College/ School/Trustee/ Registered NGO Summer/ Winter Camp, Night Sky Watch Camp, Nature Study Camp, Science Hobby Camp for School Students involving surrounding Schools by Institute/ College/ School/ Trustee/ Registered NGO Entrepreneurship Awareness Camp (EAC) for Engineering/Management/Degree/ Polytechnic/ ITI students organised by Institute/ College Skill Development Training Programme (SDTP) using New and Innovative ideas/ methods etc organised by Institute/ College/ Registered NGO/Trustee Teaching & Learning Materials & Methods for Resource Persons organised by Institute/ College/ School/Registered NGO/Trustee Faculty Development Programme for School/College/University/Institute organised by School/College/University/Institute 2 days 50 30,000 3 days 100 1,00,000 1 week 100 1,00,000 3 days 100 1,00,000 6 months 30 1,50,000 2 weeks 30 1,00,000 2 weeks 30 1,00,000 All the above figures are tentative; decision of the Competent Authority will be final. We agree to follow the General Guidelines, Terms & Conditions as stated above. Signature: Signature: Date: Name of Program Coordinator: Date: Name of Head of the Institution: Designation: Address: Designation: Address: (Office Seal) 5

Science Popularisation Programme: Summary Sheet (Mandatory) FOR OFFICE USE ONLY: Receipt No. & Date:... (1) Title of the Program:...... (2) Broad Subject area of the Program:... (3) Organisation Type (Govt./ Govt. Sponsd. / NGO/Trustee/ Private):... (4) Programme Coordinator s Name, E-mail, Mobile No., Address in details:............ (5) Total Cost of the Programme; grant expected from DHESTBT; Organisation s contribution :...... (6) Type of beneficiary (SC/ST/General):... (7) Soft Copy of the Proposal (single pdf, max size 15MB): Submitted/ Not Submitted (8) Bank A/c details, IFSC and cancelled cheque as per format: Submitted/ Not Submitted (9) Is there any other ongoing Programme funded by DHESTBT: Yes/ No (If yes, please furnish details along with the GO No.) (10) Previous U.C., SoE & Report submission date, if any:. DECLARATION I declare that I have not submitted any Science Popularisation Programme during the current financial year. Place & Date:. Signature of Programme Coordinator with official Stamp 6

Government of West Bengal Department of Higher Education, Science & Technology and Biotechnology (DHESTBT) (Science & Technology and Biotechnology Branch) Vigyan Chetana Bhavan, Block-DD, Plot-26/B, Sector-I Salt Lake, Kolkata-700064 Format for Science Popularisation Programme 1. Title of the proposed Programme:... a) Broad Subject:. b) Venue of the programme:. c) Geographical area that will be covered:. d) Target group (SC/ST/General):... e) Additional information, if any:... f) Duration and Tentative Dates on which the proposed program can be held:...... 2. a) Name and address with pin code of the Institute/Organisation with Phone, Mobile No. Fax No., e-mail id etc.:........... b) Legal status of the Institute (School/ College/University/NGO/Trustee etc.):. c) Is the Institution/Organisation is a branch of any parent organization? If so, attach certificate from the parent Organization:.. 3. Name, Designation and Bio-data of the Programme Co-ordinator (PC) including mobile no. and e-mail id (attach separate sheet):........ 7

4. Members of the organizing committee and their addresses along with their present profession and qualification: Sl Name, Address with Pin Mobile no. & Educational Present No code e-mail id Qualifications Profession 5. Whether any such Program was organized during the last three years and if so, the details thereof (attach separate sheet):........ 6. Objectives and date-wise details of the Program (attach separate sheet):........ 7. Relevance and Importance of the Program in the context of the present day scenario, local problem issues etc. (attach separate sheet):..... 8. Present activities and areas of operation in brief (attach separate sheet):.......... 9. Collaborating Institutions/Organizations, if any, with their specific contribution:. 10. Names of other organizations, if any who have been approached for funding and/or technical support:... 11. Letter from the Head of the hosting Institution/Organisation indicating willingness to held the programme (Annexure-I):. 8

12. Expected number of beneficiaries and their list duly approved by the competent authority (attach separate sheet as per the following format, if possible):. Sl Name, Address with Mobile Educational Present Age Caste No Pin code no. Qualifications Profession 13. Number and list of Resource Persons and Invited Speakers with their addresses, designations, qualifications etc. along with their consent letters (attach separate sheet as per the following format, if possible):...... Sl Name, Address with Pin Mobile no. & Educational Present No code e-mail id Qualifications Profession 14. How many delegates/ resource persons / invited speakers are proposed to be offered TA/DA: 15. Post Conference events such as follow up actions, publications of leaflets, brochure, proceedings, small group meetings etc.:... 9

16. Proposed budget showing a detailed break-up of anticipated expenses under different heads: Sl. Items required with Expenditure Institution/ Grant No. justification and rate Organization expected from Contribution DHESTBT 1. Honorarium to Resource Persons/ Experts 2. Training/ Study materials, Consumables expenses, 3. Hall rent, if any (documents to be submitted) 4. Publicity materials 5. Travel expenses 6. Documentation expenses including audio-visual systems 7. Light refreshments 8. Auditors fee (if any) 9. Other expenses, if any (please specify) Grand Total Expenditure 17. If any grant was received earlier from DHESTBT during last five year, give details (if yes, attach a copy of the submitted UC & SE):. 18. Name and address of the authority who shall be responsible for submitting the UC, audited SE, Reports, photographs etc. of the grant, if sanctioned:....... 19. Please provide the Bank details as per Annexure-II :. 20. Name, designation and address of the authority to whom allotted amount is to be sent, if any grant is sanctioned: 10

21. Check List of attachments to be submitted with the application (put ): Filled in full proposal along with the Terms & Conditions and Guidelines in the prescribed format duly recommended by Jt.BDO/ BDO/ SDO/ DM/ MLA/ MP/ Sabhadhipati etc. (for registered NGO/ Trustee): YES/NO A covering letter in Organization s letter head from the Program Co-ordinator and Head of the Institute/Organisation: YES/NO Certificate from the Head of the Organisation (Annexure I) and Bank Details (Annexure-II) in organization s letter head: YES/NO An attested copy of the registration certificate and up to date renewal certificate of the registration (for registered NGO/ Trustee) : YES/NO Last three years Audited Statement, Memorandum and Rules & Regulations of the Organization (for registered NGO/ Trustee) : YES/NO Last three years annual reports of the organization (for registered NGO/ Trustee) : YES/NO A list of the beneficiaries as given in the application format duly authenticated by the Competent Authority (Gram Pradhan/ Councilor etc.) : YES/NO Consent letters from the Resource Persons and/or Invited Speakers: YES/NO Any other information which needs separate sheet as mentioned in the application format: YES/NO Success Stories/Feedback of the earlier Programmes, if any: YES/NO D E C L A R A T I O N Certified that the details furnished above are correct to the best of our knowledge and belief and that the amount of financial assistance, if granted, will be utilized for the purpose for which it is granted within the time as prescribed by DHESTBT. We also undertake to abide by the General Guidelines, Terms & Condition prescribed by DHESTBT and provide due coverage to DHESTBT during the Program and publications/ print and electronic media made from the Program in future. Signature: Date: Name of Program Coordinator: Designation: Address: Signature: Date: Name of Head of the Institution: Designation: Address: (Office Seal) 11

Certificate from the Head of the Institute/Organisation Annexure-I Title of the proposed Programme: 1. I shall agree to abide by the General Guidelines, Terms & Condition of DHESTBT. 2. I did not submit this/ similar Program proposal elsewhere for financial support. 3. I shall agree to submit bound Program Completion Report (PCR), five original copies of UC, audited SoE, photographs/ videos/ feedbacks along with softcopy within three months after completion of the Program for which the grant received from DHESTBT. 4. Certified that my Institute/Organisation nominates Prof./Dr./Shri/Smt.... as the Programme Co-ordinator (PC) for the program and that in the unforeseen event of discontinuance by the PC, myself, being the Head of the Institution/Organisation will assume the responsibility for the fruitful completion of the program. 5. Certified that the equipment and other basic facilities as enumerated and such other administrative facilities of the Institute/Organisation, will be extended to the PC throughout the Program. 6. Institute/Organisation assumes to undertake the excess financial requirement, if any and other management responsibilities during the execution of the Program. 7. I have enclosed the following documents and ready to provide any other information as asked by DHESTBT: a. Covering letter addressed to the Competent Authority, DHESTBT: One copy b. Endorsement from the Head of the Institution & Bank Details as per Annexure-I & II (on letter head): One copy c. Date-wise details of the Programme proposal: One Copy d. Registration Certificate, Latest Renewal Receipt, Memorandum of Association, Rules & Regulations of the Association (only for Registered NGO/ Trustee): One copy e. Audited Balance Sheet, Statement of Expenditure etc. and Annual Report of last three years (only for Registered NGO/ Trustee): One copy Date:.. Place:.... Name and Signature of Head of the Organisation with Official Seal 12

Annexure-II Government of West Bengal Department of Higher Education, Science & Technology and Biotechnology (DHESTBT) (Science & Technology and Biotechnology Branch) Vigyan Chetana Bhavan, Block-DD, Plot-26/B, Sector-I Salt Lake, Kolkata-700064 BANK DETAILS OF THE APPLICANT INSTITUTION FOR RECEIVING GRANT Name of the Organisation Account number & name of the Account holder/organisation (*) Type of Account (Savings or Current A/c) Name of the Bank Name of the Branch with Branch address IFSC of the Branch Mobile Number of the Program Coordinator/Head PAN / TAN of the account holder/organisaion File Number (for Office use only) (*) Enclosures: Cancelled Cheque / Photo Copy of first page of Bank pass book Date: Signature of Authorised Person with seal 13

UTILISATION CERTIFICATE (UC) IN RESPECT OF GRANT-IN-AID No. Date: 1. Name of the Grantee Institute (s) : [Attach separate list for more than one Grantee Institution] 2. Sanctioning Authority : 3. Sanction Order Number & Date : 4. Amount Sanctioned : 5. Drawing & Disbursing Officer : 6. Treasury/PAO : [From where the bill was drawn] 7. Bill No. & Date : 8. T. V. No. & Date : 9. Amount Drawn : 10. Unspent Balance of Previous year, if any : 11. Amount Utilised : 12. Unspent Balance, if any, in Current year : 13. Purpose of Utilisation : CERTIFICATE Certified that I have satisfied myself that the conditions on which the Grant-in-Aid was sanctioned have been duly fulfilled/are being fulfilled that I have exercised the following checks to see that the money was actually utilised for the purpose for which was sanctioned. [Applicable in case of unspent balance] The unspent fund will be adjusted against the Grant-in-Aid to be sanctioned and paid in the Current Financial Year (applicable in case of recurring grant only). Kinds of checks exercised 1. Cash Book 2. Ledger 3. 4. 5. Date Signature with Official Stamp 14

Statement of Expenditure (SoE) Title of the Program:.... Duration:.. Venue:... Organized by:.... Receipts Amount Payments Amount (Rs.) (Rs.) Amount received from DHESTBT Amount received from other Institution/ Organisation/ other means etc. Amount contributed from own Institution/ Organisation/Participants etc. 1. 2. 3. 4. 5. 6. Total Total Certified that we have exercised all kinds of checks to see that the grant has been utilized for the purpose for which it was sanctioned by DHESTBT vide Order No. dated. of Rs.... Name & Signature of Program Coordinator Name & Signature of Head of the Institution Name & Signature of Chartered Accountant Office Seal with date 15

Feedback Form Title of the Programme:... Name of the Programme Coordinator:.. Name of the participant :.. Address: Age: ; Occupation: Mobile No. ; E-mail id: Educational Qualification:.. Sl No Items Rating. Please put tick () 1. Did you find the Programme useful? Very useful. Quite useful.. Not very useful Not useful at all.. 2. Did it cover what you were expecting? Yes To some extent. Not really. Not at all. 3. Please rate the speaker on his/her Lack. delivery style? Adequate. Good.. 4. How relevant was the content to your expectation? Excellent Yes.. To some extent. Not really Not at all 5. Programme duration Too short. Adequate. Too long.. 6. Are you familiar with the topics of this Programme? 7. Did you like the venue, in terms of location and comfort 8. What subject areas did you find particularly useful? 9. In terms of future Programme, are there any other related subject areas you would be interested in? (Sponsored by: DHESTBT, GoWB) Yes.. To some extent. Not really Not at all Yes.. To some extent. Not really Not at all Signature of the Participant with date 16