Application Form

NASI-Scopus Young Scientist Awards 2019

1.1. Award Category

Award Category ☐ Women in Science
☐ Agriculture, Plant Sciences and Rural Development
☐ Environmentally Sound Sustainable Development
☐ Biomedical Research and Healthcare
☐ Innovation in Engineering and Physical Sciences

1.2. Contact Information

Name
Designation
Current Affiliation
Official Address
Mobile
Phone
Email
Date of Birth

1.3. Education Qualification (From the Highest)

Degree Specialization Institution/ University Year of Completion
1.4. Research Experience
Total no. of papers published
Papers in Indian Journals
Papers in International Journals
Total no. of patents filed with
details
Previous affiliations

1.5. Please share how your research has had an impact outside its field of study & academia generally,
including any positive change (social/economic/technological etc.) brought about by, or any
interventions induced by, your research.

1.6. Your motivation for applying under the chosen category (max. 500 words)
Declaration
I hereby certify that the information in my application is complete, true and accurate to the best of
my knowledge and belief.

Full name of the applicant:

Signature of the applicant:

Place:
Date:

Document Checklist
Please print and sign this form and send it along with the following documents (in hard copy
through post/courier):
One page crisp summary of your key research achievements (preferably in bullet points). Kindly
highlight work that is closely aligned with any of the national missions.
Age proof (Only Pan Card, Passport copy, Driving License or Aadhar Card copy would be accepted)
Please attach the list of papers in a tabular format - include only original papers published in Peer
reviewed Indian/International journals. Please note the publication must be indexed in Scopus. (**There is
no need to send printouts of full length papers.)

Document Title Authors Year Journal Citations

List of patents (if applicable)

Nomination form (A nominator can be your research guide/supervisor or an eminent scientist)

Note: Please put a tick (✔) against the document attached

Address for sending the documents:

Aparajita Verma
Marketing Manager - South Asia
Elsevier Research Solutions
14th Floor, Building No: 10B
DLF Cyber City, Phase II, Gurgaon 122002, India
Note: You will be receiving an acknowledgement email from us within 15 working days of receipt of your
application.

Contact

If you have any questions related to the awards, please contact Aparajita Verma at :
Tel : +91 124 477 4632 | aparajita.verma@elsevier.com