Office Address Private Address Address Position (s) held
Academic & professional qualifications
Honours/Awards received
Memebership(s) of Societies/Associations being held
Details of your published books/monographs
A profile about you good self in about 120 words
Name of the proposed Mss
Other Two/three suggested titles
HandwrittenTypedFloppy Diskette/CDCamera-ready
ThesisResearchGeneralReference
If thesis Year awardedUniversity granted
OriginalReprintTranslationEditedComplied
Length of the Mss.
Single line spaceDouble line space
Comprising
Subject(s) covered
Area of Study
Have you used any copyright material (including International boundary map) in your work? If so, have you obtained permission for the same from the appropriate authorities?
Name and position of the person who has contributed a foreword/preamble/introduction to the Mss., If any
If there is any possibility of getting publication assistance/subsidy from any International/National Institution/Body? If so, please give detail
Has the work or its part been already published in any shape? If so, provide details.
When will be the Mss. ready for submission in all respects (including abbreviations, transliteration chart, figures, illustrations, plates, maps, bibliography, glossary, etc.)?
Synopsis of the work in 250 words and table of contents. please also mention what new ideas your book propounds. Does it fill up any gap? (Please provide on a separate sheet)
Any other information you may wish to provide
Date
Place
