MANONMANIAM SUNDARANAR UNIVERSITY TIRUNELVELI – 627 012. TAMILNADU, INDIA
APPLICATION FOR REGISTRATION FOR Ph.D. DEGREE UNDER PART TIME EXTERNAL (R/N/G*) PROGRAMME
Subject ________________________
Specialization ______________________________
1.
Name of the applicant (in BLOCK letters)
: Mr/Ms.
2.
Father’s/Husband’s Name
:
3.
Age & Date of Birth (as in SSLC)
:
4.
Mother Tongue
:
5.
Nationality
:
6.
Community (if applicable)
:
7.
Address
:
a)
Permanent
Pin Code:
PHOTO
Should be attested by the Guide SC/ST/BC/MBC/OC
b) Address to which communications are to be sent:
Phone No:
* R-Regional/N-National/G-Global
Pin Code:
Phone No:
8. Academic Record: Sl. No. 1.
Exam Passed Under Graduate Degree
Duration: _______ Yrs
Subject(s)
Year of Institution Passing (College/ University)
Class
% of Marks
Part I Part II _______ Part III Major _______
Post Graduate Degree:
2.
Duration ________ Yrs 3.
Master of Philosophy Duration : ----------- Yrs Title of M.Phil Dissertation
9.
Professional/Teaching/Research Experience : SI. No.
10.
Designation
Institution
Duration From To
Total Period Year Month
Particulars of work done
Details of Proposed Research
:
(a) Faculty in which you desire to pursue Research
: Arts(Social Science)/ Science/Law/Engineering and Technology/Education/Commerce/Indian and other Languages/Fine Arts (including Aesthetics and Sports)
(b) Area of Research
:
(c) State whether the field of your research is Interdisciplinary
:
If yes, mention the disciplines involved
:
(d) Proposed Institution & Place of Research
:
(e) Name, Designation and Address of the Supervisor who is willing to guide you for your Ph.D programme .
:
(f) Name, Designation and Address Of the Co-guide, if any
:
11.
State whether you have already registered for Ph.D Degree in any other University
:
12.
Enclosures 1. Demand Draft for Registration
:
Yes/No
Yes/No
Draft No. & Date Amount Name of the Bank Place of Bank
: : : :
2. Attested xerox copy of P.G. Convocation Certificate. 3. Attested xerox copy of M.Phil Convocation Certificate. 4. A brief resume (of about 500 words) of the proposed Research Work. 5. The Declaration Certificate from the Guide 6. Recognition Certificate (for other University Candidates) 7. Attested copy of Guideship Recognition Certificate DECLARATION BY THE CANDIDATE I hereby declare that the particulars furnished in this application are true and correct to the best of my knowledge and belief. In case any particulars furnished in this application are found incorrect, I agree to forfeit my registration, no matter at what stage of the course, I will be at that time. I am aware that the University Grants Commission (UGC) has fixed 55% of marks as the minimum eligibility for appointment as Lecturer in Colleges and Universities. Place: Date:
Signature of the Applicant
CERTIFICATE TO BE FURNISHED BY THE GUIDE I, ______________________________working as __________________________ in _____________________agree to serve as Guide for Mr/Ms__________________________ for his/her Part-time External R/N/G Ph.D Research Programme. His/Her subject area/will
_______________________________________.
I have been recognized as a Guide by the Manonmaniam Sundaranar University for guiding research work of candidates leading to Ph.D Degree in ––––––––––––––––––––––––––. (Vide MSU Communication No.______________________dated_________________) and my Date of Retirement is __________________. The following are the details about the research scholars who are pursuing research presently under my guidance and have not yet submitted their theses: Sl. No.
Name of the candidate
Full Time/ Part Time
Date of Registration
Registration Number
Signature of the Guide With office Seal
FOR OFFICE USE ONLY Date of receipt of the application
:
Date of registration
:
Register Number
:
Date of commencement of research
: