Summer Undergraduate Research Grant for Excellence

2008 SURGE Programme @ IIT Kanpur

Indian Institute of Technology Kanpur
:: Providing Research Opportunities for Undergraduate Students

NIT Student’s Application Form for 2008 SURGE Programme

Personal Information
Name:

Roll No.:

Passport Size Photo

Branch:

College/University:

Marks (%) or Equivalent:

Contact Information
Email Address:

Mobile phone (if any):

Mailing Address:

Permanent home address:

Career Goals
Write your career goals (in maximum of 100 words):
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Education and Experience

List of departmental courses that you credited:
(Add a separate sheet if required. Also, attach an attested copy of your mark-
sheet.)

Work Experience
Include research experience (if any):

Skills or Experience
(List those that would be helpful in a research project in this field, like programming,
photography, building equipment or models, etc.)
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Extracurricular activities, awards, honours, hobbies, interests, etc.

(You may include awards and honours received before joining NIT)

Research Proposal
Write on a separate sheet of paper about the area of research that you want to take up.
(maximum 300 words):

Why, in your opinion, are you the most deserving of the 2008 SURGE programme?
 Summer Undergraduate Research Grant for Excellence
2008 SURGE Programme @ IIT Kanpur
Indian Institute of Technology Kanpur
:: Providing Research Opportunities for Undergraduate Students

Certificate of Head of Department on Application for 2008

SURGE Programme

Name of the Head of Department:

Department:

College:

Dear Colleague:

I request you to sign the certificate below in support of the Student’s Application for the 2008
SURGE programme.

Thank you.
Prof. S. Sundar Kumar Iyer
Faculty Member In-Charge
2008 SURGE Programme @ IIT Kanpur

(a) The information provided by the student of this NIT in the above application for the 2008
SURGE Programme at IIT Kanpur in true to the best of my knowledge; and

(b) The student will be allowed to stay at IIT Kanpur for the full duration of 10 weeks to
participate in the 2008 SURGE Programme from May to July, 2008.

• Weekly Recommend
• Recommend
• Strongly Recommend

(Signature of Head of Department)

Comments:

Seal of the College:

Date: