sample ph.d form
DESCRIPTION
cfcvTRANSCRIPT
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Date of Registration: 17-08-2014 Reference No. : 15192228
1. Degree : Ph.D.
2. Name : Mr / Ms Kannan S
3. Date of Birth & Age : 01-05-1980
4. Gender : Male
5. Marital Status : Married
6. Community : BCM
7. E mail : [email protected]
8. Mobile : 96454535343
9. Nationality : Indian
10. Category : Part - Time
Teaching Fellow of university departments / colleges
11. Contact DetailsOffice Address Designation : Department : Organization : Place : District : CHENNAI State : Pincode : Phone :
12. Residential Details Address : SdsdDfdsDfds
Place : Sdfds District : CUDDALORE State : TAMILNADU Pincode : 76547457 Phone : 56456754
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Date of Registration: 17-08-2014 Reference No. : 15192228
13. Academic Background (Starting from the latest degree obtained)Sl.No.
Qualification Branch Mode University/Board Year ofPassing
% ofMarks /CGPA
1. M.E. Mech FT Anna 2014 92. M.E. Mech FT Anna 2013 93. B.E. 11 FT Aann 2005 904. HSC I FT State 2001 85. 10th I FT State 2006 814. Course Equivalence applied for PG Degree : NA
15. Professional Experience (Starting from the Present Employment)Sl. No. Designation College / Organisation Work Period Regular/
Temporary/ Contract
Tot Years
1.2.3.4.5. Total 0
16. Details of current employment : Employee
a) Name of the employer : Address of the employer
:
Nature of employment : Pay Scale & Working Since : & in Months
17. Details of PublicationsNo. of Journals: :No of Conferences: :Journal Details: :Conference Details: :
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Date of Registration: 17-08-2014 Reference No. : 15192228
18. Tentative title of the proposed researchtopic
: KSKDD DDD SS
19. Faculty : Mechanical Engineering
20. Details of Supervisor & Joint Supervisor
a) Supervisor Name : Dr. Fewr S Designation : Senior Assistant Professor Department : Mech Anna University,Chennai
Ref.No. for Supervisorshiprecognition
: AA
Organisation : Bbb Place : Salff District : PUDUKKOTTAI State : TAMILNADU Pincode : 43424 Mobile : 2424425435643 E Mail : [email protected] Work Place : TRICHY
b) Joint Supervisor : Not Applicable
21. Fee Details
Not Paid
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Date of Registration: 17-08-2014 Reference No. : 15192228
22. Check List
Declaration by the Candidate
Mode of UG Degree: Full-time/Part-time (day time)/Part-time (evening)/Distance/Week endMode of PG Degree: Full-time/Part-time (day time)/Part-time (evening)/Distance/Week endI hereby certify that the particulars given above are true, correct and complete to the best of my knowledge and belief. I am awarethat any wrong information or suppression of information and facts may result in punitive action in addition to cancellation of Ph.D.programme at any stage.
Place : Date : (Signature of the Candidate)
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Date of Registration: 17-08-2014 Reference No. : 15192228
Certificate from Engineering College/Research OrganizationWhere the Candidate is Employed
Certified that Mr./Ms./Mrs. ______________________ is employed as (Designation) __________________________ in the(Department / Division) __________________________ of (Engineering College / Organization)______________________________________________. The College / Organization has no objection to forward his / herapplication for admission to Ph. D. Programme.
FOR FULL-TIME:The employee will be sanctioned study leave for the minimum duration of the research programme and will be relieved from dutyfrom _______ to _______ in order to undertake Full-time research work in the University Departments/recognized Departmentsof Engineering Colleges. The necessary relieving order will be given during admission.
(OR) FOR PART-TIME:The employee will be permitted to undertake Part-time research in the University Departments/recognized departments ofEngineering Colleges and he/she will be permitted to be present for attending course works, discussion with the supervisor,conduct experiments and participate in seminars and research related discussion. Further, the required facilities at our Institute/organization will also be provided to the employee for doing research.
(Strike out whichever not applicable) Place : Date : Signature of the Principal with office seal / Signature of the
Head of the R&D organization with office seal
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Date of Registration: 17-08-2014 Reference No. : 15192228
CONSENT OF THE SUPERVISOR / JOINT SUPERVISOR
Supervisor Joint Supervisor (If applicable)
Name Dr. Fewr Dr.
Designation Senior Assistant Professor -
Nature of Appointment Regular
Department Mech -
College / Organization Address Bbb, Salff, PUDUKKOTTAI , TAMILNADU- 43424
-, - , - , - - -
Mobile No. 2424425435643
Date of Birth 03-03-1980
Date of RetirementArea of Specialization Mechanicallsj -Anna University Ref. No. forSupervisorship recognition
AA -
Department of the Supervisor isrecognized as Research Centre byAnna University or erstwhile AUTs
yes
No. of research scholars workingas on date as Supervisor
0 0
Signature
** Supervisor / Joint Supervisor are requested to read the instrucions for their eligibility as stated in Page 2 of GeneralInstructions to Candidates
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Date of Registration: 17-08-2014 Reference No. : 15192228
Details of scholars doing research under his/her guidance as Supervisor/Joint Supervisor
Sl. No. Name of the Scholar Reg. No. Ph.D. /M.S.
Supervisor / JointSupervisor
Name of the University ResearchStatus
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
(Research Status Attending Course works / Completed / Synopsis Submitted / Thesis Submitted)
Certified that I have listed all the research scholars registered under my guidance as Supervisor / Joint Supervisor.
Signature of the Supervisor/ Joint Supervisor (If applicable)(Name with seal)
(Joint Supervisor (if any) shall also submit the details of scholars registered under his/her guidance as Supervisor/Joint Supervisorin separate sheet)
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