ApplicationForm

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Page 1: ApplicationForm

INDIAN INSTITUTE OF TECHNOLOGY ROORKEEAPPLICATION FOR ADMISSION TO Ph.D. PROGRAMMES

FOR AUTUMN SEMESTER 2014-15

1. Separate Application should be used for each Department/Centre.

2. Enclose attested copies of all certificates with this Application. Bring original certificates at

the time of Interview/Test and Admission.

3. Giving false information will lead to cancellation of Admission.

4. Application incomplete in any respect, is liable to be rejected.

5. Candidates who are in the final year of their qualifying examination can be considered for

admission only if they complete the requirement of their final examination including Viva-

Voce before the registration date.

A Passport

Size

Photograph

should be

pasted in this

space

Application No: EED14201345

Name of Department/Centre in which admission is sought :EED - Electrical Engineering

Proposed Status: Full Time

Approved Research Centre: -

Mobile No. : 8971996030

NAME : K LOKESWARA RAO

Gender : Male Date of Birth : 12-Jul-1985

Nationality : Indian

Father’s Name : K NAGARAJU

Mother’s Name : K LAKSHMI

Address for Correspondence : K LOKESWARA RAO

C/O P KRISHNA MURTHY

SREE AMARESWARA SWAMI CLOTH STORES

SHOP NO 17

GEETHA MARKET

ADONI

KURNOOL DIST

Pin Code : 518301

Telephone No.:

Fax No. :

Category :OBC Person with disability (PD) : No

e-mail address : [email protected]

If PART TIME a) Whether working in a project at IIT Roorkee? : No

b) Are you an employee of IIT Roorkee? : No

c) Are you working in a Org./Univ./Inst. Approved : No

by IIT Roorkee as Research Centre?

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ACADEMIC RECORDDetails of marks/grades secured in the examinations passed.

Exam Passed Duration Subjects Institute/UniversitYear of

Passing

Marks

Obtained

% of

Marks

Max

Marks

10th Standard 1 ENGLISH,

MATHEMATICS,

SCIENCE,

SOCIAL,

HINDHI, TEL

BSE 2000 337.00 600.00 56.16

12th Standard 2 ELECTRICAL

WIRING AND

SERVICING OF

ELECTRICAL

APPL

BIE 2002 1,000.00 757.00 75.70

B TECH 3 ELECTRICAL

AND

ELECTRONICS

ENGG

JNTU

HYDERABAD

2007 4,150.00 2,555.00 61.57

M TECH 2 POWER AND

ENERGY

SYSTEMS

NIT

KARNATAKA

2009 10.00 6.95 6.95

DIPLOMA 2 ELECTRICAL

AND

ELECTRONICS

ENGG

SBTET

HYDERABAD

2004 2,000.00 1,428.00 71.40

Details of Marks/ Grade Point Average secured in the Qualifying Degree Examinations

Name of the qualifying Degree Programme: M.Tech.

Discipline/ Specialization of Qualifying Degree: POWER AND ENERGY SYSTEMS

Whether qualifying degree examination Passed: Yes

Year of passing: 2009

Name of the University/Institute: NIT KARNATAKA, SURATHKAL

Semester/Yearly SystemSemester/Year Max Marks/ScaleMarks/CGPA Obtained

Semester SystemFirst 10.00 6.90

Semester SystemSecond 10.00 6.65

Semester SystemThird 10.00 6.95

Semester SystemFourth 10.00 6.95

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GPA/ CGPA / Marks Obtained 6.950 Out of 10.000 point scale/Max.Marks

Medium of Instruction at Qualifying Examination level : English

Relevant National Level examination qualified : GATE

Year appeared 2013 Valid Upto 2015 GATE / Other score 471.00

Discipline Chosen in GATE/NET/CEED: EE

Awards and Scholarships, if any :

Any other relevant information which you want to furnish :

Research Experience Years 0 No. of papers published0

Teaching Experience (UG/PG Level) Years 5, 1 (Attach list giving details)

Professional Experience Years 5

Whether you were a student at IIT Roorkee previously and discontinued studies? No

If Yes, give particulars of the Name of Academic Programme & Department , Year(s) and the reasons for discontinuing the

programme :

Proposed Broad Area of Research :ELECTRICAL

Give Sub-Areas of Proposed research priority wise :Smart grid & Micro grid.1.

Flexible AC transmission system;2.

Power System optimization3.

Power System Instrumentation, Control and Protection4.

paragraph on how your qualifications/ experience etc. are relevant to the proposed field of your research

Presently

Working

Nature of DutiesPay ScaleDurationToFromPostOrganisation

GST

BANGALORE,

GITAM

UNIVERSITY

ASSISTANT

PROFESSOR

03-Jun-2013 04-Apr-2014 Years: 0

Months: 10

Days: 1

15600 TEACHING

RESEARCH

WORK

Y

CVR

COLLEGE OF

ENGG

ASSISTANT

PROFESSOR

01-Jun-2012 31-May-2013 Years: 0

Months: 11

Days: 30

15600 TEACHING

RESEARCH

WORK

N

VIGNAN

INISTITUTE

OF

MANAGMENT

AND

TECHNOLOG

Y FOR

WOMEN

ASSISTANT

PROFESSOR

19-Jun-2009 25-May-2012 Years: 2

Months: 11

Days: 6

15600 TEACHING

RESEARCH

WORK

N

Employment Record :

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Employed candidates seeking admission as full time / part time / sponsored category must submit Application

through their employer on the proforma given below.

NO OBJECTION / SPONSORSHIP CERTIFICATE

(Required from Full Time / Part Time / Sponsored candidates only)

The undersigned is pleased to sponsor Mr./ Ms. K LOKESWARA RAO who is working in this organisation for the last

....................... years and is presently holding the rank/ position of .............................................. for pursuing Ph .D.

programme in the Department of ................................................................................................................ with

specialisation in the following areas

1. .................................................... 2. .................................................... 3. ....................................................

His/ Her conduct and character is good.

The Institution/ Organisation would allow/relieve him/her immediately for joining the above course, if selected for

admission.

The Institution/ Organisation also agrees to PAY/ NOT PAY the contingent/ all expenses stipulated by the Institute. This

is further certified that the sponsorship for admission will not be withdrawn midway till completion of the Ph .D.

programme.

Place : ............................................. Signature of the Head of the Institution/ Organisation with seal

Date : .............................................. Name ..........................................................................

Designation .....................................................................

UNDERTAKING

I, K LOKESWARA RAO S/o, /D/o K NAGARAJU hereby undertake to abide by rules and regulations in vogue from time

to time, and shall not indulge in any act of indiscipline. The factual information given by me are correct .If at any time the

information provided by me is found to be incorrect, my admission be cancelled.

Date: ................................ Signature of Candidate

Check List

i) Attested copies of the qualifying degree/ certificate and marks sheet showing the required % of marks/CGPA.

ii) Proof from the University/Head of the Institution of having appeared/passed in the qualifying Degree Exam.

iii) Attested Copy of GATE Score Card / Equivalent National Test certificate.

iv) Attested Copy of SC/ST/OBC/PD certificate. Candidates belonging to OBC category must submit xeroxed copy of

category certificate on GOI format. OBC Certificate should have been issued after 31.03.2013 by competent authority.

v) Certificates pertaining to No Objection/ Sponsorship on the proforma of the Application Form.

vi) IITR copy of Challan

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