Admissions - M.Phil / Ph.D Application for Admission to M.Phil /Ph.D Programme

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1 Admissions - M.Phil / Ph.D Periyar Nagar, Vallam Thanjavur , Tamil Nadu, India Phone: , Fax : Web : Application No: Last date of submission: 18th July 2015 Date of Entrance Test : INSTRUCTIONS: (i) Please read the Instructions before filling the application. (ii) Please appropriate boxes wherever required. Application for Admission to M.Phil /Ph.D Programme Full Time Part Time (Ph.D) Admission is sout in the Department of. For office use only: Appeared on. Present: Yes/No Result: Selected / Not Selected /Wait listed Remarks Verified by (With Name) Closed on: 1. Course applied for : M.Phil Ph.D 2. a. Discipline : b. Broad area of research : c. Statement of purpose (SOP) (A writeup of the proposed research work around 10 lines is to be enclosed) 3. a. Name of the Candidate (English) : (In Block Letters as in Transfer Certificate) b. Name of the Candidate : (Tamil / Vernacular) 4. Date and Place of Birth : Recent passport size photograph duly attested 5. Name of the Father/Guardian in English : in Tamil / Vernacular : 6. Name of the Mother in English : in Tamil / Vernacular : 7. a. Permanent Address Door No., Street / Nagar : Village / Town : District : Pincode : b. Address for Communication Door No., Street / Nagar : Village / Town : District : Pincode : 1

2 Mobile No. : Phone No. : 8. Qualification with % of marks : (Enclose certified copy of consolidated mark list) 9. Nationality : 10. Community : General / OBC / SC / ST (Enclose CC with Attestation) 11. Caste : 12. Mother Tongue : 13. Aadhaar Card No. : 14. Do you need Accommodation in the University Hostel? : YES / NO 15. Differently Abled Persons : YES / NO (If yes, State the Nature with percentage of disabilities along with an attested copy of medical certificate issued by a registered medical practitioner, not below the rank of Civil Surgeon) 16. Are you a sponsored candidate? : YES / NO (If yes, attach the sponsorship certificate) 17. a. Details of Academic Records (from degree level with attestation): Qualifying Degree Specialisation Name of the College/ Institution University Month & Year of Passing Average % of Marks/Grade* * Average % must be based on Marks/ Grade obtained in all the Semester examinations b. GATE / UGC / CSIR / Other Score: and Year of appearance (Enclose certified copy of the score sheet) 2

3 18. Professional Experience (Research / Industrial) if any, after the Qualifying Degree Sl. No. Name of the Organization Designation & Nature of Work Period From To 19. If employed a) Regular / Temporary b) Name of the Employer c) Nature of work (Teaching / Industry / Other) d) Total Experience in years e) Monthly Income 20. Details of Papers Published in refereed Journals / Proceedings of Seminars / Conferences (Please add separate sheet, if needed) : 21. Any other relevant information : 22. Specimen Signature of the Candidate and Parent /Guardian : 23. Reference Letters (Two numbers for Ph.D Applicant) Candidate Parent / Guardian DECLARATION BY THE APPLICANT (Optional) I..(Name in full) Dauter /Son of. hereby solemnly declare that the information furnished and the statements given in the application and enclosures are correct and complete. I further declare that if found otherwise, I will be liable to forfeit my admission and / or removal from the roll of the University whatever stage of study I may be in, besides criminal prosecution. Place: Date : Signature of the Candidate 3

4 SPONSORSHIP CERTIFICATE (From the Present Employer) Certified that Mr./Ms./Mrs. is a permanent employee of and is working as.. She/He is sponsored for the M.Phil/Ph.D. Programme (Full Time/ Part Time) and all facilities will be extended to her/him during the course of study. This Organization/Department has no objection in permitting her/him to undergo the programme. She/ He has practical experience in this Organization/College for.. year/s months and.. days as on.. as detailed below. Sl. No. Description Period of Service Duration of Service From To Years Months Days Total Station: Signature of the sponsoring Authority Date & Office Seal: Name & Designation This certificate will not be valid if the Office Seal of the issuing authority is not affixed. The application of the candidates who have not furnished the sponsorship certificate in the above format will be rejected without any further communication. If the above certificate is false or contains false information, criminal/legal action will be initiated on the candidate and the concerned. 4

5 Admissions - M.Phil / Ph.D Periyar Nagar, Vallam Thanjavur , Tamil Nadu, India Phone: , Fax : Web : 1. Courses Offered a) M.Phil courses Instructions to Candidates For Admission to M.Phil / Ph.D Programme Biotechnology Management Studies Chemistry Mathematics Commerce Periyar Thout Computer Science & Applications Physics Climate Change Political Science Economics Social Work Education Solar and Bioenergies English Quality of Life Engineering Research Qualifying Examination and Eligibility Criteria Relevant P.G programme with good academic performance b) Research Programme (Ph.D) Architecture Aerospace Engineering Biotechnology (Inter disciplinary subjects are allowed) Chemical Engineering Civil Engineering Computer Science and Applications Computer Science and Engineering Electronics and Communication Engineering - Nanotechnology (Inter disciplinary subjects are allowed) Electrical and Electronics Engineering Information Technology Mechanical Engineering Software Engineering Chemistry Climate Change Education English Library and Information Science Management Studies Mathematics Physics Physical Education Political Science Periyar Thout Quality of Life Engineering Research Rural Development Solar and Bioenergies 5

6 1. Qualifying Examination and Eligibility Criteria Relevant P.G programme with good academic performance 2. Other State candidates Candidates from other states (other than Tamilnadu) are also eligible for admission to M.Phil and Ph.D programmes. They should furnish the Nativity Certificate and migration certificate issued by the competent authority. 3. Instructions for filling up the application form a) If a candidate wishes to apply for more than one course, she/he should use separate application form for each course. Only one course will be considered for one application form. b) Serial Number 1, 2, 3, 4, 5, 6, 7, 8, 11, 12, 13, 14, 15, 19, 20, 21, 22, and 23 are self- explanatory. Serial number 9 Nationality: Mention Indian or others Serial number 10, 15, 16, & 17: Mark () just above the appropriate category 4. The overall rank list will be published in the University Website: only. 5. Application form can be downloaded from the University web site or obtained from Univeristy Admission office. Duly filled in application should be sent along with a bank challan of Rs.1000/- (For SC/ST Candidates Rs.750/-) remitted in Indian Overseas Bank (Core Banking) Periyar Maniammai University Branch A/C.No.020, Pillaiyarpatti (Branch Code:1961) 6. Attested copies of the following testimonials should be enclosed with the application form. 1. S.S.L.C Mark sheet 2. HSC Mark sheet 3. Degree (UG & PG) Mark sheet 4. Transfer Certificate 5. Community Certificate 6. Citizenship (Family card issued by Civil supply office) 7. Sports, NCC, and other co- and extra curricular activities 8. Medical fitness certificate and Blood group certificate 9. Passport size Photos 5 Nos. 7. Those who have appeared for final year examinations and awaiting results can also apply. 8. Completed Application form should be sent to Registrar Periyar Maniammai University Periyar Nagar, Vallam, Thanjavur Tamil Nadu, India 9. Last date for submission of Application : Contact for any enquiries: 6

7 CERTIFICATE FOR DIFFERENTLY ABLED PERSONS This is to certify that Ms/Mr.... D/o. / S/o.Mr. aged. years is a differently abled person as defined under G.O.MS.No.198, dated of the Hier Education Department of Government of Tamilnadu. The following details regarding her / him were obtained by me after personal Examination. 1. Personal Identification Marks : (a) Recent passport size photograph duly attested by Civil Surgeon (b) 2. Nature of Disability : 3. Percentage of Disability : Further certified that she / he is physically fit to undergo hier studies including Engineering Education. Signature of the Candidate: Date: Place: Signature of the Registered Medical Practitioner (Not below the Rank of Civil Surgeon) Note: Name : Seal : 1. For differently abled category a minimum of 40% disability is required subject to the candidate s capability of carrying out all activities related to theory and practical work as applicable to M.Phil/ Ph.D. courses without any special concessions and exemptions. 2. Certificate issued on or after 1 st June 2015 will only be accepted. 7

8 2. c. STATEMENT OF PURPOSE (SOP) (A writeup of the proposed research work around 10 lines is to be enclosed) 8

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