Name (Surname, First Name) ____________________________________________
Photograph _________________________________________________
Date of Birth Place of Birth ______________________________________________
Alive (Y/N) Name of Father ________________________________________

Education (Repeatable field; Degree, Inst, Year of Passing) ___________________________________________________________________
___________________________________________________________________

Career (Repeatable field; Job title, Dept/Div/Sec, Organisation/Inst., Duration [YYYY-YY])
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Fellow (Repeatable field; Post held, Organisation, Year)
____________________________________________________________________
____________________________________________________________________

Member (Repeatable field; Post held, Organisation, Year)
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

Achievement (Repeatable field; Name of Award, Year/Duration (YYYY-YY)
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

Contribution (Invention)
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

Contribution (Publication)
_________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

Special Information
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

Address (Off) ______________________________________________________
Phone_______________________E-Mail________________________________
Address (R) ______________________________________________________
Phone_______________________

Date              ____________________  Signature______________________________

If you fulfill selection criteria of contemporary scientists mentioned in the text of the Home
page, then fill the Proforma and E-mail it to me along with your photograph so that your biography can be included in the next edition of the book.

To Download the form Click here and mail it to anjanachattopadhyay@yahoo.com