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External Engagement Permission Form
* Indicates required question
Email
*
Record my email address with my response
Requested by
*
Kindly write your official name
Your answer
Proposed Intended Activity
Type of Programme
*
Kindly tick on as appropriate. If it is not a Faculty/Staff Exchange then select other.
Faculty Exchange Programme
Staff Exchange Programme
Other:
Required
Nominated by the University
*
i.e. Nominated by GNLU. Kindly tick on an appropriate answer.
Yes
No
Required
Proposed Event Activity Chief Organiser Venue and Date
*
Your answer
Requirement
*
Duty Leave
Reimbursement (Registration Fees/Boarding/Lodging/Travelling)
Both (Duty Leave & Reimbursement (Registration Fees/Boarding/Lodging/Travelling))
Other:
Required
Intended activity
*
If type of Programme selected as "Other", then tick on appropriate from following. If Facutly/Staff Exchange tick on other
to issue a statement to the press, radio, or other public information agency
to accept an academic engagement, such as lecture, paper presentation
to accept a research, consultancy, advisory assignment, etc
to participate in a film, photo, theatre, radio or television production
to submit an article, book or other form of written material for publication
to participate in an event such as a seminar, symposium, conference, etc
to become a member of an editorial board, etc
Other:
Required
Purpose of Intended Activity and other relevant details:
(In case of a speech or written material, please include a copy of the text, and/or list of contents, as applicable).
Any Financial Gain Honorarium Fee etc
*
Yes
No
Not Finalised/ Not Known (I Shall inform the University about the amount, if any, as & when I receive the same.)
Required
If Yes then Amount
Your answer
Registration Travel Boarding and Lodging Cost
In case of a speech or written material, please include a copy of the text, and/or list of contents, as applicable
GNLU
Organiser
Self
Registration Travel Boarding and Lodging Cost Amount
eg. Rs. 350/- Three Hundred Fifty Only
Your answer
Details of your latest participation in External Programme
1 Name of the Programme
*
If no previous engagement then write "N/a"
Your answer
2 Duration
*
Kindly specify in details (i.e. From- To date & total number of days). If no previous engagement then write "N/a"
Your answer
3 Sponsored by
*
If no previous engagement then write "N/a"
Your answer
3A Sponsorship Amount
*
Write Total Amount
Your answer
3B Type of Leave Taken
*
If no previous engagement then write "N/a"
Your answer
4 Did you submit the report within five working days after participation
*
If no previous engagement then write "N/a"
Your answer
5 Did you make any follow up subsequent to your participation if yes what are the results
*
If no previous engagement then write "N/a"
Your answer
Select Preferred Section of website into which update can be made
For updating in this/these section/s you may required to contact ICT Section
My Profile Section
News/Bulletin Section
Email ID
*
type your email id
Your answer
A copy of your responses will be emailed to .
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