Award Name:

Burn off that Christmas dinner… with a 12-hour, 50-mile walk!

Title of thesis:

name of supervisor:

Department/Centre:

Category Applying for:

Date of Viva-Voce Examination:

List of Patents/Field Granted (Only related to thesis work):

Any research grant received in your group as a result of your research work:

International travel support received for thesis related work / conference etc.:

List of publications (only related to thesis work):

List of conferences where thesis related work was presented:

Any other relevant information:

Recommendation of supervisor :