Department of Science & Technology
and Biotechnology, Government of West Bengal

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Residential Science Camps

1. Proposed Programme Details:

Name of the District *
Venue of the Camp *
Name of Blocks in the district to be covered: *
Probable date (three days- two nights) of the Camp *

2.Organization Details:

Name of the Organization *
address of the Organization *
State*
District *
City / Town / Village *
P.O. *
P.S *
Pin code *
Telephone (office) *
Fax no. *
email ID *
website (if any) *
3. Programme Co-ordinator Details:

Name *
Designation *
Mobile No. *

Email-ID *
D.O.B *
Organization Department *
3. Host Organization Details:

Name of Head of the host organization *
Address *
Mobile No. *

Email-ID *
Objectives of the Camp (Within 100 words) *
Upload Day wise Camp schedule in pdf format: *
Expected outcome from the Camp (Within 200 words): *

Relevance and importance of the camp in the context of the present day scenario (Within 100 words):*

Present activities and areas of operation of Host Organization (Within 100 words): *

Names of other organizations, if any, who have been approached for teaching / technical support: *

Names of other organizations, if any, who have been approached for sponsorship / financial support: *

Name & address of participating schools: *

2. Bank Details of Applicant Institution : *

Bank Name *
Branch *
Account Holder Name *

Account Number *
IFSC Code *
Account Type *
PAN/TAN No *
Any grant was received earlier from WBSCST/DSTBT during last five year *
mention purpose of grant, year and UC & SOE submitted or not *
Name and address of the authority who shall be responsible for submitting the UC, audited SOE of the grant, reports, photographs of the camp, if sanctioned: *

4. Upload Signed Scan Copy of Complete Form (pdf): (File limit less-than 20 MB)

Upload Pdf File *
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