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Ph.D. Application Form 2011-12

This document is an application form for registering in the Ph.D. degree program in engineering and technology at the Government College of Engineering for the year 2011-12. The form requests information such as personal details, educational qualifications, GATE score if applicable, research area, experience and publications. It also contains declarations by the candidate and sections for office use and no objection/sponsorship certificates from current employers for sponsored candidates.

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vikramdasari
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51 views

Ph.D. Application Form 2011-12

This document is an application form for registering in the Ph.D. degree program in engineering and technology at the Government College of Engineering for the year 2011-12. The form requests information such as personal details, educational qualifications, GATE score if applicable, research area, experience and publications. It also contains declarations by the candidate and sections for office use and no objection/sponsorship certificates from current employers for sponsored candidates.

Uploaded by

vikramdasari
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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APPLICATION FORM

Cost of Application Form Rs. 5000/-

GOVERNMENT COLLEGE OF ENGINEERING


(An Autonomous Institute , Govt. of Maharashtra) Station Road, Osmanpura, AURANGABAD-431 005 (M.S)
In Pursuit of Global Competitiveness

Affix Passport size photograph attested by Gazzetted officer

: (0240) 2366160, 2366161, 2366111, 2334348 Fax: (0240) 2332835 E-mail: [email protected] Website: http://www.geca.ac.in APPLICATION FOR REGISTRATION OF THE Ph.D. DEGREE PROGRAMME IN ENGINEERING / TECHNOLOGY - 2011-12 Discipline: 1. 2. Full Name of Applicant:
(Starting with surname) (Capital letters only)

Correspondence Address:

Permanent address:

Email-ID : Phone / Mobile No: 3. 5. 7. 8. Date of Birth : Nationality: Category & Caste D.D. Details:
Name of Bank & Branch

Email-ID : Phone / Mobile No: 4. SEX ( ) 6. State of Domicile : Male Female

D.D. No. & Date (in chronological order) attach attested photo copies of the same
University / Board Marks Obtained out of % of Marks up to 3rd Decimal

9.

Educational Qualification
Month & Year of Passing

Name of the Examinations (from graduation)

Name & Address of Inst.

10. GATE Score: Year

(if qualified attach photo copy of the score card duly attested)

Discipline

Percentile

11. Experience: (Attach attested certificates if any)


Name of the Organization where Employed Period of Service Designation From To Reason of Leaving Remark

12. Languages / Tools of Computer programming / research known:

13. Area / Specialization in which the research is to be carried out:


(Enclose synopsis mentioning the state of the art)

14. Previous research experience / contribution: (if applicable, enclose duly signed hard copies)

15. Attested Xerox copies of the documents attached with application form. ( ) 1 Mark List of qualifying exam (M.E. / M.Tech. / M.S.) YES / NO P.G. Degree Certificate 2 YES / NO Migration Certificate 3 YES / NO Institute Leaving Certificate 4 YES / NO Employers NOC in prescribed format given below 5 YES / NO Experience certificates 6 YES / NO Caste Certificate YES / NO 7 GATE Score Card (if qualified) 8 YES / NO 16 DECLARATION by the candidate: I, hereby declare that, the information given in the application form is correct to the best of my knowledge and belief. I shall also abide the by rules and regulations of Ph.D. programme. At any stage of prosecution of my research work, if the information is found incorrect, I am aware that my candidature shall be liable for cancellation with immediate effect. Date: Place: Signature of candidate Name For office use only Marks for presentation: Marks for Interview: Marks total: Remark:

Course applied for: GATE Score (if qualified):

Scrutinized by:

Head of the Dept.

NO OBJECTION CERTIFICATE (On letterhead of the Institute /Organization)


Outward No.: Date :

To, The Principal, Govt. College of Engineering, AURANGABAD-431 005 This is to certify that Mr. / Ms ............................................................................................ . are serving in our Organization / Institution as.....................................................

Since..................The Organization / Institution has no objection to join the Ph.D. Course in Engineering at Government College of Engineering, Aurangabad. The Organization / Institution will render all possible help to him / her in persuasion of studies. He / She will be relieved for a requisite period, if selected for the course.

Official SEAL

Signature of Competent Authority Name : Designation:

SPONSORSHIP CERTIFICATE (on letterhead of the Institute / Organization) [For


Sponsored Candidates only] No: Date:

To, The Principal, Govt. College of Engineering, AURANGABAD-431 005 Sub: Sponsoring of an Employee for Ph.D. in................................ Dear Sir, I / We hereby sponsor the candidature of Mr / Mrs / Ms. An employee working in this organization, for undergoing his / her Ph.D. in ... .. Engineering at your Institute as a full time candidate. He / She is working in this organization / Institute since as

.. We shall bear the expenses of his / her studies. We shall relieve him / her for the entire period of his / her Ph.D. course as above to enable him / her to devote full time to studies, In case he /she is selected for the course. Further certified that, during his / her deputation period, the candidate would be paid his / her full salary.

Official SEAL

(Sign of sponsoring authority)

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