Questionnaire for Alumni Registration

  1. Name of Nominator
  2. Name of Nominee
  3. Relationship with Nominee
  4. Criterion(A/B/C/D)*

    Contact Details of Nominee

  5. Address
  6. Email
  7. Phone No.
  8. Year of Passing
  9. Department

    10. Present Affiliation

  10. Designation
  11. Name of Organization/Institute
Employment Details

Name of Institute/Organisation

Date of Joining

Date of Leaving

Designation

Roles and Responsibilities

Awards/Recognition/Major Milestone

Impact of work on society

+ ADD
  1. Academic Credentials

Examination/Degree

Name of Board/Institute/University

Year

% of marks scored

position of merit/ honour or medal,
if any

+ ADD

Entrepreneurial Initiatives

Name of Organisation/Start Up

Registration No. With date

No. of Employees

Approximate Turnover

Location of Operation

Is any alumnus/student of the Institute (BPPIMT) serving your organisation?

Sector of Society Impacted

Patent if any

Awards/Honours/Nominations

+ ADD

Literary/Cultural/Sports Initiatives(Category: I – Literary, II – Art & Culture, III – Sports)


Category

Serial No.

Activity/Performance

Outreach Arena (1. District 2. State 3. National 4. International)

Awards/Distinction/Nominations if any

Level of Distinction (1. District 2. State 3. National 4. International)

+ ADD
  1. Public Administration experience or Community Service, if any
  2. List of ways the nominee has remained connected with Alma Mater(BPPIMT)
  3. Upload Document

Research Credentials

Publications


Serial Number

Title of Paper/Book/Book Chapter (9.i.a)

Name of Journal/Conference/Book (9.i.b)

Year of Publication (9.i.c)

Pages, Volume(with DOI) (9.i.d)

ISSN/ISBN No. (9.i.e)

Impact Factor(9.i.f)

Indexing (SCI/ Scopus etc) (9.i.g)

Best Paper Award if any(9.i.h)

Citation Details(9.i.i)

+ ADD

Research Guidance


Serial Number

Title of Thesis/Dissertation   (9.ii.a)

Degree(ME/M.Tech/ MBA/PhD)
(9.ii.b)

Year (9.ii.c)

(Individual
or
Joint) Guidance

+ ADD

Notable Undergraduate Projects Guided


Serial Number

Title of Project   (9.iii.a)

Year (9.iii.b)

Recognition/Publication if any(9.iii.c)

+ ADD

R&D/Sponsored Projects Executed


Serial Number

Title of Project   (9.iv.a)

Funding Authority(9.iv.b)

Fund Allocated(9.iv.c)

Completed/Ongoing (9.iv.d)

Role (PI/Co PI)

Brief Description of Impact on Human lives and Nature (9.iv.e)

+ ADD

Patents if any
Awards/Distinctions/Honours from Research if any

Outreach Activities

Conference/Symposium/FDP/Workshop/Academic Events Organised

Serial No.

Event Name

Dates

Stature(National/International)

Role(Program Chair/ Organising Chair/Technical Chair etc)

No. Of Delegates

+ ADD

Invited Talks and Keynote Lectures


Serial No.

Event Name

Dates

Stature- National/International Level

Title of Lecture

No. Of Delegates

+ ADD

Sessions Chaired


Serial No.

Event Name

Dates

Stature-National/International

Title of Lecture

No. Of Delegates

+ ADD

Papers/Books Reviewed


Serial No.

Name of Journal/Conference/Book

Year

ISSN/ISBN No.

Title of Paper

+ ADD

Editorial Board Membership Details


Serial No.

Name of Journal/Proceedings/Book

Year

ISSN/ISBN No.

+ ADD

Membership of Board of studies and Course Curricula designed


Serial No.

Name of Board/Course Designed

Year

+ ADD

Membership of Professional Society and associated activity details


Serial No.

Name of Society

Role

Duration in Years

Recognition/Honour if any

+ ADD

      Consultancy Services


Serial No.

Name of Sponsoring Institute/Organisation

Nature of Services

Fund Disbursed

Duration

Whether Individual or Group Effort

+ ADD

Membership of Project Assessment Committee


Serial No.

Title of Project

Fund Amount

Funding Authority

Funded Institute/Organisation

Nature of Assessment(Technical or otherwise)

Year

+ ADD
  1. Outsourced Projects/Fund/Resources

Serial No.

Title of Project

Outsourced/Funded Institute/Organisation

Resources/Fund Amount

Duration

Completed/Ongoing

Impact of Outcome

+ ADD

Awareness Camps/Social Drives Organised


Serial No.

Subject

Time and Venue

Duration

Target Audience

Number of Participants

Impact

+ ADD


(Nominee may attach additional sheets comprising details of any other personal and professional accomplishments along with links for LinkedIn/Google Scholar/ResearchGate and of present affiliation)