Application form for reimbursement of expenses of participation in
Conference / seminar / workshop
(To be submitted by research scholar)
1. Name of the scholar:
2. Registration Date (proof to be attached):
3. Account Number: (attach bank pass book copy):
4. Account Holder Name:
5. IFSC Details:
6. Bank Address:
7. Janaadhaar Number:
8. Details required for reimbursement for participation in Conference / Seminar/
Workshop
A. Name of Conference/Seminar/Workshop:
B. Organizing Institution:
C. Duration and dates :
D. Invitation/Participation proof (Please attach copy of the email/letter issued by the program
organizing agency):
E. Registration Fees Detail (please attach proof):
F. Travel fair details (please attach proof):
G. Accommodation charges details (please attach proof):
H. Stationary expenses/Poster presentation expenses/other miscellaneous expenses (self-certified
by research scholar and verified by the supervisor/co-supervisor):
I. Recommendation of the Ph.D. Supervisor
J. Details of earlier financial support received (if any) under this scheme:
9. Declaration from the Research Scholar:
● I have not received/claimed financial support for participation in
Conference/Seminar/Workshop from any other agency/organization. I undertake, that if at any stage, it
is found to the satisfaction of the sanctioning authority that the information given by me is false or if I
violate the terms and conditions of the guidelines, the financial support sanctioned to me, may be
cancelled and the entire amount will be refunded by me or recovered from me, apart from liability for
such penal action as warranted by law
Signature
(Name of the Research Scholar)