INDIA STUDIES FELLOWSHIP COMPETITION FOR 2009-2010

This form must be prepared and submitted in accordance with the attached guidelines and returned to the following address by June 30, 2008. Programme Officer, India Studies Shastri Indo-Canadian Institute, 1402 Education Tower, 2500 University Drive NW, Calgary, Alberta, T2N 1N4
1 / Given Name: / Surname: / Gender: M F
Title: Mr. Mrs. Ms. Dr. Prof. (please circle one) / Date of Birth:
Day / Month / Year
Mailing Address: / Permanent/Home Address:
Telephone:
Facsimile:
E-mail: / Telephone:
Facsimile:
E-mail:
Communication related to this application should be sent to: Mailing Permanent
2 / Project Title
3 / Preferred Affiliation/Location of Proposed research in India:
1. / 2.
4 / Proposed Dates / Duration: months
Departure Date: / Departure Date:
(From Canada) / Day / Month / Year / (From India) / Day / Month / Year
5 / Person to be contacted in an emergency / 6 / Short Project Description (select from list in guidelines)
Name:
Mailing Address:
Telephone:
Facsimile:
E-mail: / Name Research Area:
Discipline 1:
Discipline 2:
List up to 4 Key Words or Phrases That Describe Project:
1. 2.
3. 4.
7 / Artistic Training
Institutions Attended/Teacher / Year / Degrees/Certificates Earned / Major Field of Study
8 / Occupation: Designation / Department / Institute
9 / Employment History
11 / Shastri Involvement
Please list any previous involvement with the Shastri Indo-Canadian Institute, i.e. fellowships, seminars, lectureships, performances, exhibitions etc. Please provide dates, type of award/involvement, and a summary of the results of your work including a list of publications that resulted from these awards where applicable.
12 / Support for project requested from other sources
Please list applications for research support that are pending or have been received
Organization / Amount / Status of request
13 / Other research, professional or artistic activities – must not exceed this space
14 / Relevant Distinctions, Non-Shastri Awards, or Academic/Professional Achievements - must not exceed this space
15 / List Artistic Training Supervised by the applicant - must not exceed this space
Name / Training / Title / Date of Completion

Page 6b

16 / Abstract of Project - must not exceed this page
17 / Project Description – If you do not use all pages, please do not include any blank pages. Please refer to Criteria for Project Description section in Guidelines for Applicants. Post-doctoral applicants should describe how this project relates to their doctoral work.

Page 8

17 / Project Description Continued

Page 8b

17 / Project Description Continued

Page 8c

17 / Project Description Continued.

Page 8d

18 / Please check the appropriate boxes on the right indicating that the necessary materials are included with your application.
THE APPLICANT IS RESPONSIBLE FOR ENSURING THAT THE APPLICATION IS COMPLETE. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED
1.  Twelve copies of completed Shastri Application Form (one with original signature)
2.  2 Copies of Completed Government of India Form
3.  1 Electronic copy of above two forms
4.  6 passport-sized photographs (name printed on back
5.  Proof of Canadian Citizenship
6.  2 clear photocopies of passport
7.  Itinerary for prospective stay in India
8.  5 copies of audio/video cassettes and/or portfolios (arts applicants)
9.  Certificate of Ethical Approval (if applicable)
10.  Official Transcripts (student applicants)
11.  Letters of Recommendation (student applicants)
12.  Proof of Registration in a Graduate Programme (student applicants) / Requested / Sent with Application / N/A
20 / You must provide two suggested evaluators THESE CANDIDATES CANNOT HAVE HAD A PERSONAL OR PROFESSIONAL RELATIONSHIP WITH YOU CURRENTLY OR IN THE PAST
Name:
Address:
Telephone:
Facsimile:
E-mail: / Name:
Address:
Telephone:
Facsimile:
E-mail:
21 / Signature
Applicant’s Signature Date

O1/04/2005

Page 9