भारतीय प्रौद्योगिकी संस्थान इंदौर

Indian Institute of Technology Indore

Semester Exchange Fellowship for IIT Indore UG/PG Students

(A) Personal Details

Applicant’s Full name (IN BLOCK LETTERS) *
Gender *
Date of Birth *
Postal address *
City *
State/ Province *
PIN/ ZIP Code *
Country *
Contact No. (with country code) *
Email Id *
Nationality *

(B) Academic Details

Roll Number *
Date of enrolment in the Ug/PG program *
Current Semester/Year *
Institution/College/University Name *
Complete address of the Institute/College/University with country name *
Area of Research *
(B.1) Details of the Faculty Supervisor at IIT Indore
Name *
Designation *
Department *
Contact no. *
Email ID. *
Webpage Link
(B.2) Details of the Faculty supervisor at Host Institute
Name *
Designation *
Department *
Institution/College/University Name *
Contact no. *
Email ID. *
Webpage Link

(C) Passport Details

Passport No *
Date of Issue *
Date of Expiry *
Place of Issue *
Country *

(D) Details of visit

Duration (Upto one semester-Minimum 3 months) *
From *
To *
Funding source, If any

(E) Upload Documents

Curriculum vitae of the applicant (In PDF Format less than 1.5 MB Only) *

Curriculum vitae of the faculty supervisor from the host institute (In PDF Format less than 1.5 MB Only) *

Curriculum vitae of the faculty supervisor from the IIT Indore (In PDF Format less than 1.5 MB Only ) *

Passport copy (In PDF Format less than 1.5 MB Only)*

Research Proposal (as per the template) (In PDF Format less than 1.5 MB Only) *

‘Letter of invitation’ from the applicant’s faculty supervisor from the host institute (In PDF Format less than 1.5 MB Only) *

‘Letter of consent’ from the applicant’s faculty supervisor from the IIT Indore (In PDF Format less than 1.5 MB Only) *

Upload passport size photograph (In JPG format less than 1 MB only) *

(F) Checklist of Uploaded Documents *

Curriculum vitae of student
Curriculum Vitae of Faculty supervisor of the Host Institute
Curriculum Vitae of Faculty supervisor of the IIT Indore
Passport Copy
Research Proposal
Letter of Invitation
Letter of Consent
Passport Size Photograph

Final Declaration

I declare that all the details provided in this application form are true as per my best knowledge. I agree and declare that I am solely responsible for any discrepancies, error, wrong or incorrect information supplied by me in the application form for registration. The admission will stand cancelled if any information supplied by me is found to be incorrect"

** Please check the form properly before the final submission. Any editing will not be possible after the submission of the form.

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