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Affix Passport

Sized
Photo here with
Supervisors
Signature &
Seal

[website Version]
Price Rs. 50.00

UNIVERSITY OF CALCUTTA

Website: www.caluniv.ac.in
Email: phd@caluniv.ac.in
Phone No: 22410071/22410072/22410073/22410074/22410075 Ext 258
Serial No.

Application form for Registration for the Ph.D. Programme


(To be filled in by the Candidate)

Subject (In Block Letters)

2
3

Inter disciplinary Field/Chosen area of specialization


Title of Research (In Block Letters)

4
5

Language in which the thesis is intended to be written


Name in full (In Block Letters)

Fathers/Husbands Name

Present Address in full (Residential) (In Block Letters),


Contact no. with email id if any.
Permanent Address
(In Block Letters)

Occupation / Present designation and Official Address, if


employment (NOC from employer to be attached)

10

Nationality

11

Category (Attested copy of relevant certificate for


SC/ST/OBC/PC to be attached)

12

Amount and source of research scholarship, if any or self


Financed.
Full address of the Department/Laboratory /Institution
where the research work will be carried out

13

General

SC

ST

OBC

PC

1)
2)

14

Name, Designation and Address of the Supervisor

15

Name, Designation and Address of the Joint Supervisor, if


any
Name, Designation and Address of the Associate
Supervisor, if any

16
17

Name and year of passing the qualifying examination with


the name of the University/ Institute and the subject
(Attested copy of the Certificate/Mark sheet to be attached)
18 Calcutta University Registration No. (If already registered,
attested copy to be attached)
19 Whether registered earlier under this University or
elsewhere for Ph.D. Programme (If `Yes`, furnish
document)
I declare that the items of information given above are correct to the best of my knowledge and that my Ph.D. Registration is liable to be
cancelled, if any of the above information is found to be incorrect.
Date of payment of fee:
....................................
Signature of the Candidate in full with date

(To be filled in by the Supervisor)


I certify that Sri/Sm ..will carry on his/her research
work under me for registration of his / her name for the Ph.D. Programme in
..(Name of the subject).
The number of registered Ph.D. candidates under this University working under my supervisorship till date is
I recommend Prof. / Dr .. to act as Associate Supervisor.
(Statement of this supervisor indicating the
part of research work for which the help of
the Associate Supervisor is required:
:..
.

Signature of Supervisor
..
Signature of the Associate Supervisor,
if any with Official Seal & Date

.
Signature of Supervisor
with Official Seal & Date.

...
Signature of the Joint Supervisor,
if any with Official Seal & Date

I certify that necessary space, equipment, Laboratory and other facilities will be available at the department/ Institution for carrying out
research work as proposed by the candidate.
.
Signature of Head of the Institution (Non CU), or
.
Head of the Sister Institute
with seal and date.
Date:

Signature with Seal and date


of
the Head of the Department (C.U).
Da te:

In the case of students of other Universities, necessary application for migration and registration should be submitted to the Registrar
separately along with Migration Certificate in original and usual migration and registration fees immediately after registration for the
Ph.D. Programme.
A fee of Rs. 500/- (non-refundable) is to be paid along with this application after verification by the Ph.D. Section.
Documents to be submitted at the time of applying for Ph.D. registration
1. Xerox copy of the filled in application form along with this original form.
2. Two Xerox copies (attested) of Master Degree Mark sheet/ Certificate.
3. Two Xerox copies (attested) of Calcutta University registration certificate.
4. Six copies of Synopsis duly countersigned by the Supervisor with Seal.
5. No objection certificate from employer in original along with a Xerox copy of the same, in case of employed applicant.
6. Two photographs (Passport size), one to be affixed on this form with the Supervisors signature & seal and one without
signature & seal to be attached (for use in the Ph.D. registration letter) with this form.
7. Two attested copies of probationary Ph.D. student` enrolment certificate for the Ph.D. programme issued by the concerned
University department. Not meant for sister Institute candidate.
8. The equivalence certificate issued by the University of Calcutta for qualifying degree obtained by the students from other
Universities.
9. In case of change of subject the endorsement of concerned Ph.D committee is required (Vide 3.3 & 4.9 of the new Ph.D
regulation). Meant for Sister Institute candidates only.
10. Xerox copy of the relevant certificate for SC/ST/OBC/PC.

For use of the Ph. D Committee.

UNIVERSITY OF CALCUTTA
Ph. D. PROGRAMME REPORT ON DEPARTMENTAL SEMINAR
1

Name of the Candidate

Subject

Title of the Thesis

University Department where the Seminar was held:

Date of the Seminar


We certify that the above candidate presented his / her work in a Departmental Seminar in defance of his/ her thesis in our
presence in the University Department of on
ata.m /p.m.
1 ..
3..
5..

2
4
6...

Signature of the Convener and Members of the Ph.D. Committee

.........................................................................
Signature of the Supervisor and Joint Supervisor
Date :
Report on the performance of the candidate

Date :

.
Signature of the Convener of the Ph.D. Committee
(Additional Sheets, duly signed may be annexed, if necessary)

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