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APPLICATION FORM FOR FULL TIME PHD/ M.SC. (ENGG) BY RESEARCHFOR THE ACADEMIC YEAR 2019
Self attested photograph to be pasted
Applied for : Ph.D M.Sc. (Engg.)
Name :
Father’s Name:
Email :
Date of Birth :
Category : GM SC ST Cat-I Physically challenged Others
Gender : FemaleMale
Marital Status : Married Unmarried
Qualifications : GATE Score (if available) Valid Up to :
VISVESVARAYA TECHNOLOGICAL UNIVERSITY (VTU) RECOGNIZED RESEARCH CENTRE
ProgrammeDegree
ObtainedBoard/
UniversityRegular / Distance
Specialisation% Marks
obtained with Class
Year of Passing
PG
UG
Diploma *****
XII/PUC***** *****
X / SSLC ***** *****
Experience (in years)
Fresher Industry Teaching
Research
Publications / Recognitions
Number of Research papers Patents Awards
Area of Interest :
Declaration by the Applicant:
I hereby acknowledge that all the information given by me are true ______________________________________________
to the best of my knowledge.
Signature of the Candidate Date :
Enclose self attested copies of the following along with the application
1 Detailed Bio-data
2 SSLC/X marks card
3 PUC/XII marks card
4 Diploma Certificate (if applicable)
5 UG degree Certificate
6 PG degree Certificate (if applicable)
7Test Score Card along with Admission ticket in support of clearance of GATE with valid score (if available)
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