University of Calcutta Application Form for Travel Grant Application Number: For Office Use Part A (To be completed with Part B) (Please use BLOCK LETTERS to fill this form) NAME: Contact Number: Designation: Department/Centre: E-mail: Event Details Name of Conference/Seminar/Workshop/Symposia Scope/Type: (Please tick) International National Event Venue: Country: Event Date: (dd/mm/yyyy) City: From To Participation Details Purpose/Nature of Participation (Please tick) Delivering key-note addresses/ plenary lectures Oral presentation of a paper Poster presentation of a paper Chair a session Participate in International Collaboration Exchange programmes Symposia/ talks/ invited lectures Title of Presentation/Lecture Fund Related Details Total amount of grant required (INR): (In words) Whether availed such grant in past (For travelling abroad) (For travelling within India) Within last 6 months (Please tick) Within last 3 years Between last 3 to 6 years Not within last 6 months Never Not within last 6 years Never Whether applied/will apply for fund from other sources: Yes No Necessary Endorsements Applicant Date: Supervisor (For Student/Research Scholar) Head of Department (with seal) University of Calcutta Application Form for Travel Grant Part B (To be submitted with Part A) Check-list for supporting documents: (for Office use) 1..
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