Step by Step Instructions to fill the Online Application form:

1. Clicking the SAVE AS DRAFT button will only save the form filled so far. Please note that this
does not mean that your form has been submitted. You can save your progress any number
of times before clicking the SUBMIT button, which will finally submit the form.
2. An applicant can’t submit the form unless all compulsory fields have been filled and all
required documents have been uploaded.
3. Once submitted the form can’t be altered without providing special admin rights that will be
controlled by the backend team/CII
4. Field marked with * are mandatory fields.

STEP 1: Personal Details

Prefix* Select your name Prefix.
Enter your First name.

Note: The name you enter here must be

First Name* exactly what will be used for all official
documentation and can’t be changed. Be
careful with what you enter as your First,
Middle & Last name.
Middle Name Enter your middle name (Not compulsory)

Last Name* Enter your Last name.

Gender* Select your gender.

Click on the box provided and you can select
Date of Birth*
the date month and year from the calendar.
Enter your valid personal Email Id.

Note: This email ID will be used for all future

Email*
correspondence hence be very careful while
keying this in.

Enter your 10 digit mobile No. (Don’t append 0

or +91 before your No.).
Mobile* Note: We will be contacting you on this
number for any requirements. So be very
careful while keying this in.
Father’s name* Enter your father’s full name.

Marital status* Select your marital status.

Nationality* Select your nationality.

Attach your Passport size photo in .JPG, .PNG
Passport size photo*
format.

Complete Permanent Address

Address* Enter your permanent address.

State* Select your state.

Select your city.
Note: If your city is not found then select
City*
‘Other’ option. And give your city name in the
field provided for the Other City.
Other City Enter your city name in case of ‘Other’

Pin code* Enter your 6 digit pin code.

Complete Postal Address(Select check box if same as permanent Address)

Address* Enter your postal address.

State* Select your state.

Select your city.
Note: If your city is not found then select
City*
‘Other’ option. And give your city name in the
field provided for the Other City.
Other City Enter your city name in case of ‘Other’
Pin code* Enter your 6 digit pin code.

Step 2: Details of PHD

Click on the box provided and you can select
Date of Enrolment in PHD*
the date month and year from the calendar.
Click on the box provided and you can select
the date month and year from the calendar.

Note: This date may be the same as enrolment

date in case of some institute / university rules
Date of Registration in PHD*
A candidate is eligible to apply for PM
Fellowship if she/he has been registered for
PhD for not more than 14 months from the
date of submission of application

Attach the PHD Enrolment certificate in DOC

PHD Enrolment certificate*
format.
Attach the PHD Registration certificate in DOC
PHD Registration certificate*
format.
Enter name of Institute where enrolled /
Institute where enrolled / registered in PHD*
registered in PHD.
Enter the name of University (Not
University
Compulsory).

Nature of PHD enrolled/registered in* Select the nature of PHD enrolled/ registered.

Address* Enter the address of institute.

State* Select the State.

Select your city.

Note: If your city is not found then select
City*
‘Other’ option. And give your city name in the
field provided for the Other City.

Pin code* Enter the 6 digit pin code.

Other City Enter your city name in case of ‘Other’

 Select the Broad Research Area from the six
listed areas of Life Science, Engineering,
Broad Research Area*
Mathematics, Physics, Chemistry and Earth &
Atmospheric Sciences
Enter the sub classification of research area
Sub Classification Area* E.g. Civil Engineering, Agriculture, Medicine
etc.
Enter the research topic.
Note: Please do not enter a very long research
topic. Keep it concise. This is the topic of
Research Topic*
research that you propose to work on under
PM Fellowship Scheme.

Enter your research synopsis.

Note: The research synopsis should not be
more than 300 words. The synopsis should
Research Synopsis* reflect clarity of thoughts and objective. Try to
highlight the importance of the research to
industry.

List of publications Enter the publication List.

Step 3 Educational Details

Details of 10th Board

Select your board (If you select Other then

Board*
define your board).
Subjects Taken* Enter your 10th subjects.

Year of Passing Select passing year of 10th board.

Enter your percentage in 10th
Percentage obtained in 10th *
Note: Do not enter best of 4 or best of 5 etc.
Upload scan copy of your 10th certificate in
Upload scan copy of your 10th certificate*
DOC format.

Details of 12th Board

 Select your board (If you select Other then
Board*
define your board).
Subjects Taken* Enter your 10th subjects.

Year of Enrollment* Select enrollment year of 12th Board.

Year of Passing Select passing year of 12th board.

Enter your percentage in 12th
Percentage obtained in 12th *
Do not enter best of 4 or best of 5 etc.
Upload scan copy of your 12th certificate in
Upload scan copy of your 12th certificate*
DOC format.

Details of Graduation Degree

Enter your graduation degree name.

Name of Graduation Degree*
E.g. B. Sc., B.Tech etc.
Select graduation type.
Type of Graduation Degree*
Enter Graduation specialization
Specialization* E.g. Pharmacy, Physics, Mechanical
Engineering
Enter subjects taken in Graduation
E.g. In B.Sc (H) Biochemistry, you may have
Subjects* taken Immunology, Microbiology,
Biomolecules, Mathematics, Chemistry etc. as
subjects.
Enter the total percentage marks or CGPA, as
Total Percentage / CGPA Scored* applicable, scored in Graduation. Do not enter
best of 4 or best of 5 etc.
Institute* Enter your graduation institute.
Enter your graduation university (Not
University
compulsory).
Year of Enrollment* Select enrollment year of Graduation.

Year of Passing Select passing year of Graduation.

Upload scan copy of your graduation Upload scan copy of your graduation
certificate* certificate in DOC format.

Select if you taken admission in PHD directly after Graduation

Details of Post Graduation Degree

Name of Post Graduation Degree* Enter your post graduation degree name.

Specialization* Enter post Graduation specialization.

Subjects* Enter post Graduation subject.

Enter the total percentage marks or CGPA, as
Total Percentage / CGPA Scored* applicable, scored in Graduation. Do not enter
best of 4 or best of 5 etc.
Institute* Enter your post graduation institute.
Enter your post graduation university (Not
University
compulsory).
Year of Enrollment* Select enrollment year of post Graduation.

Year of Passing Select passing year of post Graduation.

Upload scan copy of your post graduation Upload scan copy of your post graduation
certificate* certificate in DOC format.

Details of Other degree/diploma (not compulsory)

Name of Other Degree Enter your other degree name.

Specialization Enter other degree specialization.

Subjects Enter other degree subject.

 Enter the total percentage marks or CGPA, as
Total Percentage / CGPA Scored* applicable, scored in Graduation. Do not enter
best of 4 or best of 5 etc.
Institute Enter your other degree institute.
Enter your other degree university (Not
University
compulsory).
Year of Enrollment Select enrollment year of other degree.

Year of Passing Select passing year of other degree.

Upload scan copy of your Other degree Upload scan copy of your other degree
certificate certificate in DOC format.

STEP 4 Host Institute (PHD) Details

Name of institute where Registered for PHD* Enter the institute name

Name of Department* Enter the name of department

Address* Enter the Address

State* Select the State

Select city. If city is not found then select
City* ‘Other’ option. And give city name in the field
provided for the Other City.
Other City Enter city name in case of ‘Other’

Pin code* Enter the 6 digit Pin code

PhD Institute STD Code* Enter the STD Code for the Phone No.

PhD Institute Phone No.* Enter the valid phone no.

Enter the valid website URL (not including
PHD Institute Website*
HTTP)
Upload profile of Host Institute* Attach Profile of host institute in DOC format.
Do you avail the hostel facility at your Select Yes/No (If yes then fill following address
institute* fields)
Address Enter the Address
State Select the State
Select city. If city is not found then select
City ‘Other’ option. And give city name in the field
provided for the Other City.
Other City Enter your city name in case of ‘Other’

Pin code Enter the valid 6 digit pin code

Details of PhD Institute Head

Name of Head of PHD Institute* Enter the name of Head

PhD Institute Head Designation* Enter the Head Designation

PhD Institute Head Address* Enter the Address

PhD Institute Head State* Select the State

Select your city. If your city is not found then
PhD Institute Head City* select ‘Other’ option. And give your city name
in the field provided for the Other City.
Other City Enter your city name in case of ‘Other’

PhD Institute Head Pin code* Enter the pin code

Step 5 Academic Guide Details

Details of the1st Supervisor/ Research guide for Phd

Prefix* Select name Prefix

Full name* Enter the full name of 1st supervisor

Enter your 10 digit mobile No. (Don’t append 0
Mobile*
or +91 before your No.).
Email* Enter the valid Email ID

Bio data of PHD Supervisor* Attach the Bio data of PHD Supervisor

Details of the 2nd Supervisor/ Research guide for PhD

Prefix* Select the name prefix of 2nd supervisor

Full name* Enter the name of 2nd supervisor

STEP 6 Partner company Details

Details of Partner Company

Name of Partner company* Enter the name of partner company

Enter the valid website URL (not including

Partner Company website*
HTTP)

Address* Enter the Address

State* Select the State

Select your city. If your city is not found then

City* select ‘Other’ option. And give your city name
in the field provided for the Other City.

Other City Enter your city name in case of ‘Other’

Pin code* Enter the Pin code

Enter the Annual Turnover of Partner

Annual Turnover of Partner Company*
Company.
 Attach the Partner company Logo in JPG/PNG
Partner Company Logo*
format
Attach the Partner company profile in DOC
Partner Company Profile*
format.

Details of Partner Company Head

Head of partner company* Enter the name of partner company head.

Enter the Designation of head of partner

Designation of head of partner company*
company

Address of Head of partner company* Enter the Address of Head of partner company

State of Head of partner company* Select State of Head of partner company

City of Head of partner company* Select City of Head of partner company

Other City Enter your city name in case of ‘Other’

Pin code of Head of partner company* Enter Pin code of Head of partner company

STEP 7 Industry Mentor Details

Prefix* Select name Prefix

Full Name* Enter the full name of the Mentor

Enter your 10 digit mobile No. (Don’t append 0
Mobile*
or +91 before your No.).
Email* Enter the valid Email id of the Mentor

Address* Enter the address of the mentor

State* Select the Mentor the state
Select your city. If your city is not found then
City* select ‘Other’ option. And give your city name
in the field provided for the Other City.
Other City Enter your city name in case of ‘Other’

Pin code* Entre the valid 6 digit pin code

STD Code* Enter the valid STD Code

Phone No.* Enter the valid Phone No.

Attach the Bio data of Industry Mentor in Doc
Upload Bio data of Industry Mentor*
Format

STEP 8 Current Employment/ Fellowship Details

Currently availing any fellowship* Select Yes/No

If Yes then fill the Following two details

Name of the agency providing fellowship* Enter the name of agency

Are you interested in switching over Present
fellowship to the PM’s Fellowship for the Select Yes/No
Doctoral Research*

Are You Currently employed in some

Select Yes/No
job/assignment*

If Yes then fill the Following details

Name of the Employer* Enter the name of Employer

 Enter your job designation.
Job assignment description/ designation* E.g Quality Manager, Web Developer, Project
Associate
Address* Enter the address

State* Select the State

Select your city. If your city is not found then
City* select ‘Other’ option. And give your city name
in the field provided for the Other City.
Other City Enter your city name in case of ‘Other’

Pin code* Enter the valid 6 digit Pin code

STEP 9 Undertaking & other Documents

Attach the Undertaking from the Research
Undertaking from the Research Supervisor and
Supervisor and Head of the Organization of
Head of the Institute / University*
the Institute / University in doc Format.

Undertaking from the Industry Partner in the Attach the Undertaking from the Industry
Research Project* Partner in the Research Project in doc format

Attach the Letter from the Industry Partner

Letter from the Industry Partner (on
(on company’s letterhead) on the research
company’s letterhead) on the research
problem and the future plans for
problem and the future plans for
implementation, if any in doc format (not
implementation, if any
compulsory)

STEP 10 Declaration & Submit

Declare that all the information given by is true to best of your knowledge and finally submit
your application form.