The Biotech Research Society - AMI- INDIA



218122547625 Association of Microbiologists of India Association of Microbiologists of India AWARD NOMINATION FORM We, the Life members of Association of Microbiologists of India (AMI) would like to proposeName: Date of Birth: Position: Address: ……….……………………………………………………………………………………………………………………………….……………………………………for the AMI-Prof. S.R. Vyas Memorial Award (Biennial),AMI Life Time Achievement Award, AMI- Dr. G. B. Manjrekar award (Biennial), AMI-Louis Pasteur Award (Triennial), AMI- Dr. AMI-Prof. B.N. Johri Award for Microbial Diversity/AMI-Young Scientists Awards in (Area:…………………. ………………………………………..) Awards for the year 2020 (must whichever is applicable). ProposerSeconderSignature: …………………………….. Signature: ………………………………..Name: ……………………………………… Name ………………………………………Address: …………………………………… Address: ……….……………………………………………………………………………………………………………Date:………….…………………………….. Date: …………..………………………..…..Station:……………………………………... Station: ……………………………….……..INSTRUCTIONSThe soft copy of the nomination as a single PDF file by email at gs2020ami@ and one printed copy + the soft copy on a CD by speed post to the address: Professor Namita Singh, GENERAL SECRETARY,?THE ASSOCIATION OF MICROBIOLOGISTS OF INDIA (AMI), Department of Bio & Nano Technology, Guru Jambheshwar University of Science & Technology, Hisar-125001, Haryana, India.DEADLINE: 30th September, 2020PART I: Biodata of the NomineeName:Designation:Date of birth:Age on 31st August 2020: …… years .. ..months…… daysNationality:Membership no. of AMI:Official address (with telephone, Mobile and email):Residential address:Educational qualifications (in chronological order from degree onwards):Professional experience (in chronological order):Research and teaching experience (years only):Area of R&D and specialization:Publications (mention here numbers only and attach the full list)Patents :Books:Chapters in the Books:Research Papers (SCI journal only):Poster/oral/abstract in conferences/symposia:Awards/honors/distinctions (attach separate sheet):List five most important publications and attach reprints (attach separate sheet, if necessary). Indicate impact factor of the papers publication.Contribution made by the nominee to strengthen the AMI. PART IIProofs and details of achievements To be filled by the nominee/proposer (must see and follow the instructions to fill the columns)Each claim MUST be supported by relevant document, failing which that would not be consideredS NoCredentials Proof enclosure no/ Flag No1Patents2Papers published/accepted in SCI journals3Book chapters in books 4Awards (International/ National)5Fellow of national/international academies/societies6Thesis supervised (degree awarded only)7Best paper/poster award- National/international conference8Editor of book published 9Author of book published10Editorial board member of SCI journal11Fellowships/Professorship any other international organization/university 12Fellowship/scholarship/grants/awards to attend international conference/workshop/symposium 13NET/GATE / DBT/ICMR/ICAR qualification to do PhD 14Technologies transferred to industries15Google scholar Citation of the nominee’s work*Without flags in hard copy, documents will not be entertained.This is to certify the information and proofs given in this nomination form are correct.Date:Date:Signature of the applicant/nomineeSignature by the proposer ................
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