BHARATHIAR UNIVERSITY,COIMBATORE 641 046

Established by Tamilnadu State Legislature under the Bharathiar University Act 1981 (Tamilnadu Act 1 of 1982) Accredited with A Grade by NAAC APPLICATION FOR ADMISSION TO PART TIME Ph.D. (Category B)

Session: JULY / DECEMBER

* Payment of fee
Affix recent passport size photo

Amount: __________

DD No: _________ Date D M Y

Subject for Research (based on P.G. Degree)

Specialization

1. Name (In Block Letters as in records) :

2. Sex : Male / Female 3. Age: yrs D 4. Date of Birth : M Y

5. Nationality : 6. Religion :

7. Community : ______________________ BC / MBC / DNT / SC / ST Other Specify:

8. Address : (a) Permanent (with e-mail Id) .. .. .. Pin.

(b) Address to which communications are to be sent (in India only) (with e-mail Id) . .. .. Pin.

9. a) Name, Occupation and address of father / guardian b) Name of mother

: :

* An application fee of Rs. 1000/- (non- refundable) should be paid in the form of DD. A demand draft should be taken in a scheduled bank in favour of Registrar, Bharathiar University, payable at Coimbatore. The DD should be submitted along with the application form. Please refer the Regulations/Eligibility conditions for admission.

10. Present occupation of the candidate : and place where working 11. Academic Particulars : (enclose the attested Xerox copy) Exam. passed PUC / +2 Bachelor Degree Master Degree M.Phil. Degree 12. Professional / Teaching / Research Experience : Designation Institution Duration From To Total Period Y M D Particulars of work done Major subject BOARD / Univ. Month & yr of passing Duration of course Class % of marks obtained obtained

13. Details of proposed research (a). Broad field of research : (should be related to the main branch of PG Degree) : (enclose a brief resume of 250 words) (b). Scholarship, if any awarded, for the present research programme: 14. Awards / Medals / Prizes / Honours achieved :

15. * (a). Name of Research Supervisor (b). Institution where Supervisor is working

: :

(i). Whether the Research Supervisor has applied for Registration under the scheme (ii). Whether the Research Supervisor has been Registered. If so date and number of Registration No. 16. Any other particulars

Yes / No Yes / No Date:

* Research Supervisors may be chosen from the Pool of Research Supervisors posted in the University Website http: //www.b-u.ac.in

DECLARATION BY THE RESEARCH SUPERVISOR

I ____________________________ (M / F) aged __________ Recognized as a Research Supervisor for Ph.D. programme by _________________________ University, _______________ state, hereby accept to guide and supervise the candidate Mr. / Mrs. / Miss. _________________ for Ph.D. programme under the above mentioned scheme. I will abide by the rules and regulations of the Ph.D. programme. Place : Date : Signature Name : :

Address for Communication

Phone: Land Line: (including code)

Mobile: E Mail:

DECLARATION BY THE CANDIDATE

I ____________________________ (M / F) aged_________, S/O, D/O, W/O, H/O ______________________ declare that all the above mentioned details are true to the best of my knowledge and belief and assure that I will abide by the rules and regulations of the Part Time Ph.D. Category-B Place : Date : Signature Name : :

Address for Communication

Phone: Land Line: (including code)

Mobile: E Mail:

ENCLOSURES NEEDED

1. Copies of marks and degree certificates for S.S.L.C./+2/ U.G./P.G. and M.Phil. 2. DD / Challan for payment of Application fee. 3. Transfer Certificate copy from the previous institution of study. 4. Conduct Certificate copy from Head of the department of study / Senior Faculty (Institution where studied). 5. Self-addressed stamped (Rs.5/-) envelope 2 Nos. & Post Card 2 Nos. 6. Copy of the Service Certificate. * Application may be sent to:The Director Research and Development Centre Bharathiar University, Coimbatore Tamilnadu, India. Pin 641 046 DD in favour of THE REGISTRAR, BHARATHIAR UNIVERSITY payable at Coimbatore. NOTE

1. Envelopes may be superscribed as Application for Admission to Part Time Ph.D. (Category B) 2. For eligibility conditions and further information, visit http: //www.b-u.ac.in Academic -- Part-time Ph.D. 3. Last date for submission of the application : 31st May 31st October for July Session and for December Session.