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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 Amount: __________


Subject for Research …………………………
DD No: ___________ Date
Specialization ………………………… D M Y
Proposed Place of Research :
Department: ……………………………. Institution ………………………….
(Indicate the Department and Institution where the candidate proposes to do research. For e.g.:
Department of Physics, Bharathiar University or Department of Chemistry, Government Arts
College, Coimbatore.)
1. Name (In Block Letters as in records) : ………………………………………………………
2. Sex : M / F 5. Nationality : 7. Community
3. Age: yrs __________________________
6. Religion :
BC / MBC / DNT / SC / ST / Other

D M Y
4. Date of
Birth :

8. Address : (a) Permanent (b) Address to which communications are to be sent

…………………………………………………...... …………………………………………………......

……………………………………………….. ………………………………………………..

……………………………………….. ………………………………………..

…………………Pin………… …………………Pin…………

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


b). Name of mother :

* An application fee of Rs. 100/- 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.
10. Present occupation of the candidate :
and place where working
11. Academic Particulars :
Exam. passed. BOARD / Univ. Month & yr Duration Class Major % of marks
of passing of course obtained subjects obtained
PUC / +2
Bachelor
Degree
Master
Degree
M.Phil
Degree
12. Professional / Teaching / Research Experience :

Designation Institution Duration Total Period Particulars of


From To Y M D work done

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 Yes / No
(ii). Whether the Research Supervisor has been Registered.
If so date and number of Registration Yes / No
No. Date:
16. Any other particulars

* 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 : Signature :

Date : Name :

Address for Communication

Phone: Land Line: Mobile:


(including code) 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 : Signature :
Date : Name :
Address for Communication

Phone: Land Line: Mobile:


(including code) E – Mail:
Enclosures needed:
1. Copies of marks and degree certificates for PG 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)
* Application may be sent to the
The Director
Research and Development Centre
Bharathiar University, Coimbatore
Tamilnadu, India. Pin – 641 046

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
3. Applications will be received till 31st May for July Session and 31st October for December
Session.