PhD Guide Application Form

FORM OF APPLICATION FOR RECOGNITION AS Ph.D. SUPERVISOR

1. Name (in Block Letters) :

2. Designation/Official Address :



3. Date of Birth :

4. Phone No. & E-Mail :

5. Qualifications (start with highest to lowest) :

Degree*
Name of College /
School & Location
University
Period attended
From To
Area of
Specialization
Class / Rank /
Percentage
Furnish the details in separate sheet as per the format
* State whether Part time (P) Full time (F) Correspondence (C)

6. i) Total Experience (No. of Years) ** :

Name of Institution &
Place
Duration
Designation
Reasons for
Leaving
From To
Furnish the details in separate sheet as per the format
** Attach copies of certificates / proof
ii) Teaching Experience (No. of years) :
iii) Practical / Industrial Experience (No. of yrs). :
7. Membership in Professional Societies :




8. Number of Sponsored Research Projects :
(as Principal Investigator give details separately)

[Declared as Deemed –to-be-University under Sec.3 of the UGC Act, 1956]
KARUNYA NAGAR, COIMBATORE – 641 114
9. Research Guidance (No. of Thesis guided)
(a) Ph.D Thesis :
(b) Master's/M.Phil. Thesis :

10. Publications (Please attach list of publications and reprints of at least
two publications published recently in National/International J ournals/
refereed Conference Proceedings)

(a) Number of papers in Referred J ournals
i) National J ournals :
ii) International J ournals :
(b) Number of Papers published in refereed
Conference Proceedings :

11. Any other information :
Signature with date
Note : All the attachments should bear the candidate’s signature

Encl: (1) List of Publications (2) Reprints
(3) Other Information & Xerox copy of Ph.D. Degree Certificate

No-Objection Certificate from the employer (for external candidates only)

I forward the application of our employee Dr…………………………………………… …. who wish
to guide the Research Scholars of Karunya University. Our organization has no objection in guiding
Research Scholars of Karunya University by him / her.

Name & Designation : Head of the Organisation


- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - For Office use - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Whether the certificates of the candidate are verified: YES / NO

Remarks :

RECOMMENDED / NOT RECOMMENDED



Head of t he Depar t ment


Di r ect or of School

Approved by the Board of Research & Consultancy in its meeting held on ......…………

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

RECOMMENDED AND FORWARDED TO ACADEMIC COUNCIL


DEAN (RESEARCH)