F.No. 30- I /2019-ES.3 Government of India Ministry of Human Resource Development Department of Higher Education External Scholarship Division

PUBLIC NOTICE

The Chulabhorn Graduate Institute, , is offering l0 scholarships to Non- ASEAN applicants for the Academic Year 2020 under the 'Chulabhorn Graduate Institute post Graduate Scholarship Program for Non-ASEAN Applicants. The programs in which the Institute is offering scholarships are: Environmental Health, Environmental Toxicology and Chemical .

The 2- eligibility criteria, application form and other details are annexed herewith. Applicants are required to e-mail a scanned copy of the fully filled application form and other supporting documents to cgi academic@cgi'ac.th . In addition, applicants are also required to send the original application and other supporting documents to the following address: The Chulabhorn Graduate Institute 906 Kamphangphet 6 Road, Talat Bang Khen, Laksi, Bangkok 10210 Thailand

3' The last date for sending applications for the Chulabhorn Graduate Institute post Graduate Scholarship Program for Non-ASEAN Applicants is 30,h octobe r 2019.

(Visalakshi Jayaraman) Under Secretary to the Government of India Tele: 01126172492 Dated the 09,h August 2019 w C}{UI,A13HOI1N ROYAI, ACADEMY Chulahhorn Craduirrr Institurc

Chulabhorn Graduate Institute post-graduate Scholarship Program for NON-ASEAN Applicants

(Academic Year 2020)

The Chulabhorn Cracluate Institute (CGI) is a nrultidisciplinary post-graduate academic institute established in 2005, under the initiative of Prof-essor Dr. Her Rr:yal Highness Princess Clhulabhorn Mahidol. The airn of CCI is to ernploy the most recenr inreractive teaching techniques used in leading educational and research institutions to produce effectivc thinkers and leaders to better serve their countries' needs towards sustainable development. The CGI is presently oflbring programs lcading to Master's and Doctoral Degree in Applied Biological : Environmental Health, Environmental Toxicology, and Chemical Science.

This year. 10 (ten) scholarships are avnilable fbr NON-ASEAN intemational applicants to pursue a Master's f)egree study at the CCI. Selection of applicants rvill bs based on nrcrit.

Eligibility

Scholarshil)s arc epcrl to the eligible applicants who mcet the fbllowing qualifications:

I ) Undcr 30 years r:{'age 2) Hold a Bachelor Degree with a cumulative GPA of at least 3.00 in one o{'the ttrllorving tlelds: o Sciences: Chernistry, Biological, Biological Sciences, Molecular ', Environmental Sciences o N{edical Sciences: Meclicine, Medical Technology o Phannacy or Pharmaceutical Sciences Applicants Iionr other rel*ted fields are also welcome to apply.

*1) Have e.xperience in scientitic laboratory research 4i N4ust have demonstrate

' Applied Biological Sciences: Iinvircximental Health . [nvironmentall'oxicology . Chemical Sciences

Scholarship Coverage

The scholarship ivill cover tuition and other academic fees. rr:und hip airfare. accommodation, monthly stipend, book allowance, health insurance and others.

Arvard Period

The scholarship arvard rvill cover 6 u,eeks retiesher courses and frrllou, by a period of 2 years \4aster's Degree stlldy, subject to an annual review ofthe scholar's satisfactory progress.

Note: Retiesher Courses will tentatively commence in June 2020 u,hile the academic program rvill commence in August 2020.

Application Procedure

Applicants should complete the Chulabhom Graduate lnstitute Post - Craduate scholarship PiJgrarn's application {irnn (for NON-ASEAN) and submit together rvith other supporting documerlts through the fbllowing channel:

( I ) Send via e-mail the scan file of the application fbnn and all the supporting document to:

1'he Chulabhorn Craduate Institute (CCI Scholarship Prr:gram) 54 Kamphangphet 6 Road, Talat Bang Khen. Laksi, Bangkok 10210 THAILAND Ernail : cgi-acaclemic(a)cgi.ac.th

as stated in (2) After stcp ( I ) send all the original documents via postal selvices to the address (1).

Note: No consideration rvill be given to application with incomplete of supporting documents. Supporting f)ocument

Following documents must be subrnitted together rvith applicalion fbrm:

l) Full Acaclemic Transcript

2)'l'hrce Recornmendation Lctters

3) Staternent of Purpose explaining interest of study

4) Medical History Report

5) Other supporting docunrents to facilitate application screeniltg

Application Period

Applications fcrr the CGI Post-graduate Scholarship Program are due on 30 October 2019.

Notification of the Award

Successful applicants will be notitied of the outcome by the CGI around January 2020'

Application Form

CICI scholarship application fbnn antl nredical history report can be found as the attachments-

['or more information, please contact

.,lddress: 'Ihe Chulabhom Graduate lnstitute 54 Karnphalgphet 6 Road, Talat Bang Khen. Laksi, Bangkok 10210 TIIAIIAND E-mail: cgi*aoademic@)cgi.ac.th Website : US1it-,ggl. ac.lh Tel Nos: (66 2) 554-1900 ext.2155,2130 Iiax Nos: (66 2) 554-1990 / 554-199? Place Photograph . \,J, \.. "i/\ ) Here (]IILILAI}[IORN ROYAL A(;AI}T}{Y t;hulihhom (;rtduarr l$*riturr

Chulabhorn Graduate lnstitute Post-Graduate Scholarship Program Scholarship Application Form (For NON-ASEAN Applicants)

INI PORTANT I NSTRUCTIONS: . Each question must tre answered clearly and cornpletely. . Duly completed application forms should be tbrwarded to the Chulabhom Craduate .lnstitute before deadline of application o lncomnlete anplications.will not be coJrsideled.

Proposed field of study: fl Appliecl Biological Sciences: Environmental Health

fJ En ironmental Toxicology

D Cnemical Sciences

PERSONAI, DAl'A

'l'itlc F'arnily nflIlle / Surnumt I irst nrrrne Sex (ns shorvn in passport)

E tvtr. I Male

D Mrs. ] remale I trt..

Religion -ity and country of birth Nationality Date of Birth Age Marital (DD,MMA Y) status

Single

Married

Divorced C:0 NI l\'I tI N I Cl ;\'[ I O N AN D lvl A t L I N G A DD R t] S S

Appl icant's 0l'llce Address: Applicant's Honre Address:

0lllce telephone NO; Ii;\X: Florrre lelephunu N0: FAX:

Clountryl ;\rcai N utttber Clountryi Areal Nurnber tlountryl Areal Nurnber CountrnlAreal Numtrer 0llicc Email: Pcrsonal [.mail:

Name and address of person to be notified in case of emergency:

T Nn Relntionshin: Clountryl Arcal Nuurber lnternationaI Airport / City of Departure

EDI"JCA'I'ION RNC'ORD

Degrees, Diplomas or Certificates

i for how long?

(do not attach details) E]II PI-OYN,T ENT RECOITD

Ycars ol seruir"rc (l}un-to): Years of service (tiom-to):

Title of' your postiposition:

T.v'pe o l' -your organization: Type of your organization:

Govenrnrent,' Sertri Governmenl/ Private/ NCO Cot ernrnentl Semi Coverntnent/ Private/ NGO N'tain function of the organization: Main function of the organization:

Office address:

Dcscription ol'your work including your responsibilitics (Please continue on supplementary 1:ages if neccssar-y) EXPECTATIONS

PIease desuibe the practical u*e i the rcsponsibilities you expect to assumc and the condition exisiing in your country in rhe held *l'your training. (Please continue on supplementary pages if necesiaryi

I,ANGUAG[S (No consideraticxr will bc given to applicants without language proficiency tcst

Maiher tonguc

English

0ther

English Proficiency Test* (please atlach)

I tnutl score I I rElrs score .

I lOther (specify) t Required Information

Page 4 of5 pages .S TiPPORI'I NC DOCUMENTS

l--ll ,.unrrript (s)

[-l ,"u*. of Recommendation

nallre title in.stitution/company

name title institution/company

title institutiorucompany

l-l u"oi.at Certificate l-l otn"rs (Please specify)

Please read the following and sign

I understand that withholcling peninent infonnation requested in this application form eir intentionally giving false information will make me automatically ineligible lbr application consideration. I hereby certify that my education and qualifications are in accorclance with the admission requirenrents and all inlhrmation givcn in this form is true.

Applicant's Signature

Duly completed application tonn should be forwarded to:

The Chulabhom Graduate Institute 906 Kamphangphet 6 Road, Talat Bang Khen.

Laksi, Bangkok 10210 T[{AILAND Email: cBi-academiciii)cgi.ac.tir http:llwww,cgi.ac.th

Pags 5 of5 pages Countrl,

*Physical Exanrination (To be filled in by physician)

Ilcight cms. weight . tlro.d pressurc kgs. mm.Hg. purse . /nrin. vision Right t-efi . Eyrs With glasses / without glasses a) Do you curently use any

( ) Yes : name of medication ( ), Quantity ( b) Are you pregnanr?

( )No

t )Yes:( rnonths)

c) Are you allergic to any medication or foocl? ( )No

( )Yes: ( )Medication:( )Food:( )Other:

l,aborato{y Examinations

Blood group ...Bltxrd film for maluria .,...... 1-lb ,...... gm,/o

wBC . f)ells/cu.mrn.

a/a Dillbrential PMN ...... % Lymp ...... Mono ....oh Eos ...... "...... yo

Baso ...... % Band...... o/o Blast. ....-.o/o

Urinalysis: Colour ...... Sp. Cr...... pH Sugar

Alh...... Blood ...Kctones Blie..

lvlicro: WBC. ..../HPF.,RBC...... /HpF.,Epethelial...... /l{pF.

Casts...... / HPD., Others

Stool cxamirration for parasite & Ova

ChestX-Rayreport

Urine pregnanc)" test Chcck each item in approprirt; cotrrmn

Itcm Nornral Abnormrl Additional comment Ccnsral t:fl Skin. Scalp tl tl l.ymph nodes tl tl Eyes tl n Ears tl tl Otoscopic Exam

Nose fl tl Pharynx & tonsils I T Teeth n D "l'hyroid gland tl n Lungs tl n Hear1 tl D Abdomen n tl Liver tl tf Spleen tl n Hernin tl tf Extemal genitalia tl tl Rectal exarn. tl tf Vertebrae tl tf Locomotor tl tl Rel'lexes n tf Mentalhealth status n I

.t ! t: .-.{!i&}-, ;?i?&..'d a a/ j!,;;3?:ti:; t-l?l?ylu-l ou W lrrnlni a nrriqfrufi n Entnyernrni

cBA 003(1)/12s : )ane 27,2019

H.E. Ms. Suchitra Durai Ambassador flxtraordinary and Ptenipotentiary & Permanent Representative to UNESCAP The Embassy of the Repubtic of lndia Bangkok, THAILAND

Subject The Chutabhorn Graduate lnstitute Post Graduate Scho[arship

LxceItency,

We have the honor to inform Your Exceltenry that The Chutabhorn Graduate lnstitute, for academic year 2020, wil.t arnard a number of schotarships to quatified candidates to urrdertake Master Degree study in rrarious fietds in kience and Technol.ogy. The scholarship wi[[ cover round trip airfare, tuition and other academic fees, accommodation, montlrly stipend, hook allowance, heatth insurance and others. We woutd greatly appreciate Your Lxcel.tenry cooperation in conveying the tt: aforementiorrecl inlorrnation to Your Exceltenry government and invite retevant organizations nomina Attached herewith are the announcement, apptication forrvr and other related docurnents.

Please accept, Excetlency, the renewed assurance of my highest consideration'

(ou^l*h R*.A'^t,a'

(Professor Erneritus Dr. Somsak Ruchirawat) Rector, Chutabhorn Graciuate lnstitute

Enclosure: fu stated