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
Affix recent
Passport size
photo

Amount: __________

DD No: ___________ Date

D

Subject for Research .

Specialization
(based on P.G. Degree)
(not more than four words) (IN CAPITAL LETTERS)

1. Name (In Block Letters as in records) :

5. Nationality :

2. Sex : M / F
3. Age:

6. Religion

yrs
D

7. Community

______________________
BC / MBC / DNT / SC / ST
Other

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. 1000/- 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 : (if secured below 55% in PG Degree, enclose a Undertaking with endorsement of the Notary)
Exam. passed.

BOARD / Univ.

(mention the subject)

Month & yr
of passing

Duration
of course

Class
obtained

Major
% of marks
subjects obtained

PUC / +2
Bachelor
Degree
Master
Degree
M.Phil.
Degree
12. Professional / Teaching / Research Experience :
Designation

Institution

Duration
From
To

Total Period
Y
M
D

Particulars of
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 proposal 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

[with seal]

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 (Provisional/Convocation) for

U.G./PG and M.Phil. (need not enclose the mark statement copies).
2. DD / Challan for payment of Application fee
3. Transfer Certificate copy from

the previous institution of study

4. Conduct Certificate copy from

5. Undertaking with endorsement of the Notary (if necessary)

* Application may be sent to the
The Director
Research & 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 ----- Academic ---- Part-time Ph.D. Research & Development
3. Applications will be received till 31st

May

for July Session and

31st October for December Session.