Phd Admission

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Indian Institute of Science Education and Research Bhopal
APPLICATION FORM FOR ADMISSION INTO THE Ph.D. PROGRAMME
Programme
Discipline
Ph.D.
Biological Sciences Chemistry Earth and Environmental Sciences Mathematics Physics
Personal Information
1. Full Name
2. Father’s Name
3. Date of Birth 4. Place of Birth
5. Nationality 6. Gender
7. (b) Minority (a) Religion
10. Address for
Correspondence
11. Permanent
Address
Mobile Landline
E-mail
Academic Record/Work Experience
Paste Your
Recent Photograph
Here
13. [a] Qualifying degree already obtained or in progress (Attach self attested copies of all semester marksheets/certificates)
Institute/College/University Discipline Degree Exam Date Marks %
or

Marks % or CPI/GPA
Sem I. Sem. II Sem. III Sem. IV
Overall Marks % or
CPI/GPA
(If Degree Completed)
Sem. V Sem. VI Sem. VII Sem. VIII
(Month-Year)
Completion/
Expected
Completion Date CPI/GPA
(Month-Year)
13.
CSIR-JRF
DBT-JRF
UGC-JRF
GATE
ICMR-JRF
JEST
NBHM-JRF
Others, Please specify
Valid upto
Valid upto
Valid upto
Valid upto
Valid upto
Valid upto
Valid upto
Rank
Rank
Rank
Rank
Rank
Rank
Rank
Subject
Subject
Subject
Subject
Financial Status
Valid upto Rank
[b] National level qualifying examination (Tick the relevant box only if you have qualified the exam)
(Attach self attested copies of scorecard/certificates)
12. Contact
8. Category
9.Physical Disability
CSIR-JRF
DBT-JRF
UGC-JRF
GATE
ICMR-JRF
JEST
NBHM-JRF
Others, Please specify
CSIR-JRF
DBT-JRF
UGC-JRF
GATE
ICMR-JRF
JEST
NBHM-JRF
Others, Please specify




Indian Institute of Science Education and Research Bhopal
APPLICATION FORM FOR ADMISSION INTO THE Ph.D.PROGRAMME
13.
Examination
Subjects
Degree/Diploma
(eg. B.Sc./
M.Tech.)
% of Mark
CPI/GPA
Obtained
Year of
Passing
13.
[d] Work Experience
(A candidate presently working (including those on projects) must provide a “No Objection/Relieving certificate” from the employer)
Employer
Position From Date To Date Nature of Work
13. [e] Number of publications (Enclose only the title page of each journal publication)
Published in journals Presented at conferences
Pref. 1:
Name of Board/University
Secondary
Higher Secondary
Bachelors Degree
Others, if any
Remarks/
Distinction/
Division
14. Describe briefly your research experience during or after the Masters degree, if any:
15. Attach as a separate sheet, a Statement of Purpose (SOP) not exceeding 150 words. The SOP should describe
how your research interests match with the research areas currently represented in the discipline you have applied to
at IISER Bhopal
[c] Details of academic record
(Do not include the degree listed in 13.[a])
Indian Institute of Science Education and Research Bhopal
APPLICATION FORM FOR ADMISSION INTO THE Ph.D.PROGRAMME
17. Contact details of the referees (Letters of recommendation should be provided in the specified format)
Referee 1 Referee 2
Name
Designation
Affiliation/Address
Contact No.
E-mail Address
18. Declaration by the applicant
Certified, that all information provided by me in this form is correct to the best of my knowledge and belief.
I understand that any willful misrepresentation of facts will result in my dismissal from the Institute. If admitted,
I shall abide by all the rules and regulations of the Institute.
16. Preferred area of specialization in the programme/discipline
Broad research area
Sub-areas, if applicable
Broad research area
Sub-areas, if applicable
Broad research area
Sub-areas, if applicable
Preference 1
Preference 2
Preference 3
Date: Click Here Applicant’s Signature
Place:
Fill the entries on the form neatly (Either TYPE or WRITE in Block Letters)
Options:
7 (a). Religion: e.g., Hindu, Islam, Christian, Sikh etc.
7 (b). Minority: Yes/No
8. Category: SC- Scheduled Caste/ST- Scheduled Tribe/OBC- Other Backward Class/GN - General
9. Physical disability: Yes/No
13.[b] Financial Status: Sponsored (Having external fellowship e.g. CSIR-JRF)/Institute assistantship requested
Checklist (circle the enclosed documents). Send self attested copies (not originals) for item no. 1 to 6:
1. Date of Birth (DOB) certificate or high school (Class X) certificate with DOB (required for all applicants)
2. SC/ST/OBC (non-creamy layer) certificate, if applicable
3. Certificate of physical disability, with type of disability, to be attached, if applicable
4. GATE/CSIR/UGC/others. Eligibility/sponsorship certificate/score-card, or copy of result with your roll number
highlighted (required for all applicants)
5. Copies of mark/grade sheets (required for all applicants)
6. No Objection/relieving certificate from employer (only for employed applicants)
7. Two letters of recommendation in the specified format, if not sent via e-mail.
Note:
Recommendation letters may be sent with the application packet in hardcopy in sealed envelopes, superscribed "Letter
of Recommendation for <Applicant's Name> to Ph.D. Program in <Discipline Name>" at below mentioned
address or via E-mail with subject "Recommendation letter for <Applicant's Name> to Ph.D. Program in <Discipline
Name>" to coordinator ([BIO]-"[email protected]"/ [CHM]-"[email protected]"/[EES]-
"[email protected]"/ [MTH]-"[email protected]"/[PHY]- "[email protected]") of
the discipline to which the applicant has applied.
Letter of recommendation not sent via email or in a sealed envelope will not be accepted.
Hard copy of application along with all enclosures must be sent to:
The Coordinator, Academic Affairs
Indian Institute of Science Education and Research Bhopal
Indore By-pass Road, Bhauri, Bhopal - 462 066
Madhya Pradesh, India
NOTE: PLEASE SUPERSCRIBE YOUR ENVELOPE WITH “APPLICATION FOR Ph.D. IN (DEPARTMENT NAME)”
For example, if you are applying to the Ph.D. programme in Physics, please superscribe your envelope with
“Application for Ph.D. in PHYSICS”.
Separate application must be sent for each programme.
Minimum Qualifications:
M.Sc./M.Tech. Degree (minimum 60% marks) or CGPA 7.0 with a valid GATE/UGC/CSIR/NEST/ICMR/DBT/
NBHM or any other recognized score.
Reservation:
As per Government of India rules.
INSTRUCTIONS FOR FILLING THIS FORM

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