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MANONMANIAM SUNDARANAR UNIVERSITY

TIRUNELVELI – 627 012. TAMILNADU, INDIA

APPLICATION FOR REGISTRATION FOR Ph.D. DEGREE


UNDER
PART TIME EXTERNAL (R/N/G*) PROGRAMME

Subject ________________________ Specialization ______________________________

1. Name of the applicant : Mr/Ms.


(in BLOCK letters)

2. Father’s/Husband’s Name :
PHOTO
3. Age & Date of Birth :
(as in SSLC)

4. Mother Tongue :
Should be attested
5. Nationality : by the Guide

6. Community (if applicable) : SC/ST/BC/MBC/OC

7. Address :

a) Permanent b) Address to which communications


are to be sent:

Pin Code: Phone No: Pin Code: Phone No:

* R-Regional/N-National/G-Global
8. Academic Record:

Sl. Exam Year of Institution % of


Subject(s) Class
No. Passed Passing (College/ University) Marks
1. Under Graduate
Degree Part I
Part II
Duration: _______
_______ Yrs Part III
Major
_______
2. Post Graduate
Degree:
Duration
________ Yrs
3. Master of
Philosophy
Duration :

----------- Yrs

Title of M.Phil
Dissertation

9. Professional/Teaching/Research Experience :

SI. Designation Institution Duration Total Period Particulars of


No. From To Year Month work done

10. Details of Proposed Research :

(a) Faculty in which you desire to : Arts(Social Science)/ Science/Law/Engineering and


pursue Research Technology/Education/Commerce/Indian and other
Languages/Fine Arts (including Aesthetics and Sports)

(b) Area of Research :


(c) State whether the field of your research is : Yes/No
Interdisciplinary

If yes, mention the disciplines involved :

(d) Proposed Institution & Place of Research :

(e) Name, Designation and Address of the :


Supervisor who is willing to guide you
for your Ph.D programme .

(f) Name, Designation and Address :


Of the Co-guide, if any

11. State whether you have already registered : Yes/No


for Ph.D Degree in any other University

12. Enclosures
1. Demand Draft for Registration : Draft No. & Date :
Amount :
Name of the Bank :
Place of Bank :

2. Attested xerox copy of P.G. Convocation Certificate.


3. Attested xerox copy of M.Phil Convocation Certificate.
4. A brief resume (of about 500 words) of the proposed Research Work.
5. The Declaration Certificate from the Guide
6. Recognition Certificate (for other University Candidates)
7. Attested copy of Guideship Recognition Certificate

DECLARATION BY THE CANDIDATE

I hereby declare that the particulars furnished in this application are true and correct
to the best of my knowledge and belief. In case any particulars furnished in this application are
found incorrect, I agree to forfeit my registration, no matter at what stage of the course, I will be at
that time.
I am aware that the University Grants Commission (UGC) has fixed 55% of marks as
the minimum eligibility for appointment as Lecturer in Colleges and Universities.

Place:

Date: Signature of the Applicant


CERTIFICATE TO BE FURNISHED BY THE GUIDE

I, ______________________________working as __________________________ in
_____________________agree to serve as Guide for Mr/Ms__________________________ for
his/her Part-time External R/N/G Ph.D Research Programme.

His/Her subject area/will _______________________________________.

I have been recognized as a Guide by the Manonmaniam Sundaranar University for


guiding research work of candidates leading to Ph.D Degree in ––––––––––––––––––––––––––.
(Vide MSU Communication No.______________________dated_________________) and my
Date of Retirement is __________________.

The following are the details about the research scholars who are pursuing research
presently under my guidance and have not yet submitted their theses:

Sl. Name of the candidate Full Time/ Date of Registration


No. Part Time Registration Number

Signature of the Guide


With office Seal

FOR OFFICE USE ONLY

Date of receipt of the application :


Date of registration :
Register Number :
Date of commencement of research :