Application 2015 PhD

Category : GM SC ST CAT-I Physically Challenged Others

Male Female Name: ......Date of Birth:....

Fathers Name:.. Academic Qualification:

ProgrammeDegree obtainedUniversityRegular /Distance Specialization% Marks obtained with ClassYear of passing

UG

PG

Others if any

No. of years of experience: Industry: Teaching: Research:

Number of Research papers: Patents: Awards: Topic of Research proposed:

Proposed course work Sl.No.Subject CodeSubject Title

114PHDRMResearch Methodology

2

3

4

5

6

Research Centre 1. VTU-RC: .Department:....Recognized: Yes No

2. VTU-R&D: Department:.....Recognized: Yes No

3. VTU-RRC: Belagavi. Department...

Application and Processing Fee Details: D.D. for `. 800/- No.:Drawn on Bank...date:.Applicants Address for correspondence

Information of the Supervisor Information of the SupervisorName: Date of Birth...Affiliation : Department:

DesignationArea of Research

Academic Qualification:

ProgrammeDegree obtainedUniversityRegular /Distance Specialization% Marks obtained with ClassYear of passing

UG

PG

Ph.D.

Others if any

No. of Publications in the preceding 5 years: Research papers: 1. National Journal communicated: 1. National Journal

2. International Journal 1. 2. International Journal Conference: Technical Reports: Book: Patents: Awards: No. of students Supervising: Sl.

No.Name of the Candidate/sProgrammePlease tick (()University CategoryYear of registrationSpecify whether acting as Supervisor or Co Supervisor Area of SpecializationWhether Final Thesis Submitted (Y/N)

Ph.D. M.Sc. (Engg)

1

2

3

4

5

6

7

8

Total

Undertaking from the Supervisor

Information of the Co-Supervisor( if applicable)Name: .Date of Birth...

Affiliation: . .. Department:

DesignationArea of Research

Academic Qualification:

ProgrammeDegree obtainedUniversityRegular /Distance Specialization% Marks obtained with ClassYear of passing

UG

PG

Ph.D.

Others if any

No. of Publications in the preceding 5 years: Research papers: 1. National Journal communicated: 1. National Journal

2. International Journal 1. 2. International Journal Conference: Technical Reports: Book: Patents: Awards: No. of students Supervising:

Sl.

No.Name of the Candidate/sProgrammePlease tick (()University CategoryYear of registrationSpecify whether acting as Supervisor or Co SupervisorArea of SpecializationWhether Final Thesis Submitted (Y/N)

Ph.D. M.Sc. (Engg)

1

2

3

4

5

6

7

8

Total

Undertaking from the Co-Supervisor

Undertaking by Supervisor / Co-Supervisor *(in case Co-Supervisor is opted)

No Objection Certificate of the Organisation

Employment Certificate of the Supervisor

Employment Certificate of the Co-Supervisor (in case Co-Supervisor is opted) Supervisors Address for correspondence

Co-Supervisors Address for correspondence

Application No.

APPLICATION FORM FOR VTU RESEARCH APTITUDE TEST (VRAT)

Test Centre Code: Bengaluru Belagavi Kalaburagi None

Programme Stream Applied for:

1. Mechanical Engineering 7. Bio-Technology 13. Maths

2. Computer Science Engineering 8. Polymer Science 14. Physics.

3. Electrical Engineering 9. Silk Technology 15. Chemistry4. Civil Engineering 10. Textile 16. Management Studies 5. Environmental Engineering 11. Chemical 17. Computer Applications 6 . Architecture. 12. Geology 18. Library Science 1 17. Statistics

19. Physical EducationEducational Qualification which makes you eligible for the Programme ProgramDegree AwardedSpecialisationPercentage of Marks/CGPA with Class Specify Regular or Distance Education

UG

PG

Nationality: Indian Others (NRI/FN/PIO): Gender: Male Female

Category: General SC ST Cat-1 OBC Any Other.

Whether Physically challenged Yes No : If Yes, Nature of disability:....

Specify the status of VTU TAT: Cleared in July 2010 Cleared in Jan 2011 Cleared in July 2011

Write the TAT Seat No.

National Test qualified with valid score .Are you a faculty under QIP/FIP: Yes No

Address for correspondence:

Exemption from VRATThe following categories of candidates will be exempted from appearing at the VRAT:(a) Faculty Members under QIP / FIP and (b) Candidates qualified in UGC-CSIR ,JRF.

If you possess VTU -VRAT validity, then provide Seat No :...Declaration by the Candidate

Visit www.vtu.ac.in for Recognized Research Centres, Fee Structure and Syllabus for VRAT.

VISVESVARAYA TECHNOLOGICAL UNIVERSITY, BELAGAVI, KARNATAKA

EMBED MSPhotoEd.3

To be filled by candidates

Name:

Address.

.......................................

Programme applied for:

..

Paste ( do not pin ) passport size photograph in this space and get it attested by Principal / Head of College / University last attended or a Gazetted Officer

APPLICATION FORM FOR PhD/ M.Sc. (Engg) by Research

for the academic year 2015-16

Research Centre applied for: VTU-RC VTU-R&D VTU-RRC

Faculty Applied for : Engineering Architecture Science Management Studies

Full time Part time Programme Applied for: Ph.D. M.Sc.(Engg)

This is to certify that the Organisation has no objection in recommending the candidature of our employeefor carrying out research for his/her Ph.D./ M.Sc. (Engg.) by research at .... on part time / full time basis. The information provided by the candidate is found correct as per our records.

Signature of the Principal/Head with Seal.

I / We have no objection in guiding the said candidate in the proposed area of research at the designated Research Centre. If for any reason, myself /candidate change the Research Centre, I /we will inform the same to the University without fail.

Signature of Co-Supervisor Signature of the Supervisor

Signature of the Head of the Institution where the research work is proposed:.

I, is a permanent faculty /employee working as . in the Department of . in the organisation .......and is aged less than 65 years as on the date of admission notification hereby certify that the candidate Mr./Mrs....registering for ..... degree under VTU is not my son/daughter/immediate blood relative and the total number of candidates registered under me in VTU and other Universities for both Ph.D. & M.Sc. (Engg.) by Research taken together excluding presently applied candidates is (in Words). The information provided above is true to the best of my knowledge.

Date:

Place:

Signature : _________________________________________

Forwarded by ,...

Date: Signature of the Principal/Director/Head of the Research Centre with Seal

I, is a permanent faculty /employee working as . in the Department of . in the organisation .......and is aged less than 65 years as on the date of admission notification, hereby certify that the candidate Mr./Mrs....registering for ..... degree under VTU is not my son/daughter/immediate blood relative and the total number of candidates registered under me in VTU and other Universities for both Ph.D. & M.Sc. (Engg.) by Research taken together excluding presently applied candidates is (in Words) The information provided above is true to the best of my knowledge.

Date:

Place:

Signature : _________________________________________

Forwarded by ,...

Date: Signature of the Principal/Director/Head of the Research Centre with Seal

For Office Use only

Enclose attested copies of the following, before sending the application :Detailed Bio-data of the Candidate, Supervisor (and Co-Supervisor, if applicable)8.Any other additional Certificates supporting your claim for benefits like:

Medical Certificate for the degree of disability in support of candidates claiming benefit

Test Score Card along with Admission ticket in support of clearance of UGC-CSIR ,JRF.

In case candidate/Supervisors are possessing degree from Foreign Universities, The Equivalence Certificate issued by the Association of Indian Universities( AIU)

Passport with Visa in the case of Foreign candidates

UG and PG degree Certificates and Marks cards of the Candidate UG, PG and PhD Degree Certificates of the Supervisor/Co-supervisorCategory certificate of candidates belonging to SC/ST/Cat-I/ and any other if applicableSynopsis of the proposed researchSyllabus of the Course work chosen for the present study

Demand Draft of `.800 drawn in favour of The Finance Officer, VTU, Belagavi towards Application and Processing fee

..

Phone No.. email_id: ..

.

Paste ( do not pin ) passport size photograph in this space and get it attested by Principal / Head of College / University last attended or a Gazetted Officer

Candidates Signature

Date of VRAT:

Test Centre:

Reporting Time:

Seat No.:

Note:

1. This Form should be filled by all the candidates irrespective of their eligibility to be exempted from the VRAT as such an exemption is subject to a thorough scrutiny of supporting documents satisfactorily provided by the candidate along with this Application

VISVESVARAYA TECHNOLOGICAL UNIVERSITY

Jnana sangama

Belagavi-590 018, Karnataka, India

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I hereby acknowledge that all the information given by me are true to the best of my knowledge. In the event of any information being found incorrect or misleading, my candidature shall be liable to cancellation by the University at any time and I shall not be entitled for refund of any fee paid by me to the University. I have carefully studied the Regulations(Amended) Governing the Degree of Doctor of Philosophy (Ph.D.)-2014 framed under Section 32 of VTU Act 1994.

Date:Signature of the Candidate

..

Phone No.. email_id:

.

For those having validity of VTU Tech. Aptitude Test

This is to certify that Dr. presently working in the capacity ofin the Department of... is a full time employee of our Organisation, since..

Organisation: Seal and Signature of the

Head of the Organisation

.

Ph.D./M.Sc.(Engg)

Name of the Applicant: Name of the Supervisor : .....

Name of the Co-Supervisor:.

Research Centre(VTU-RC/VTU-RRC):...

Programme:..

Mobile No: Phone ..

..

Phone/Cell No.. email_id: ..

.

This is to certify that Dr presently working in the capacity ofin the Department of... is a full time employee of our Organisation, since..

Organisation: .. Seal and Signature of the

Head of the Organisation

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