Nomination form for Kaikini Scholarships

(To be filled by faculty members/Department Chairs)

Nominee information:

Name of the student:____________________________________________________

S.R. No.: ____________________________________________________________

Department: _________________________________________________________

Faculty (tick whichever is applicable): Science / Engineering

Email address: ________________________________________________________

CGPA: ______________________________________________________________

Nominator:

Name:______________________________________________________________

Designation:__________________________________________________________

Department:__________________________________________________________

Along with this filled form, please enclose the following:

1) Recommendation letter from PhD advisor/Department Chair
2) Copy of students CV
3) Copies of students transcripts

The soft copy of the filled form along with the above documents should be sent to:
development@odaa.iisc.ernet.in (mandatory)

The hard copies of the filled form and documents can be sent to the Office of Development and
Alumni Affairs (ODAA), Bungalow no. 11, Gulmohar Marg (optional).

Deadline for submission: June 30, 2017