PhD MS App10

8/8/2019 PhD MS App10

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NAAC ACCREDITED

Application No: Last date for submission: 18.06.2010

Application for Admission to M.Phil / Ph.D Programme (Full Time / Part Time)

Admission is sought in the Department of……………………….

1.Course applied for : M.Phil Ph.D

2. Discipline :

3.Name of the Candidate

(IN BLOCK LETTERS) : Ms./Mr.

4.Date and Place of Birth :

5.Name of the Father / Guardian :

6. Name of the Mother :

7.a. Permanent Address :

7.b. Address for Communication :

Phone No. :

E-mail :

8. Qualifications with % of marks :

(Enclose certified copy of mark list)

9. Nationality :

M.Phil / Ph.D Admission

RecentPassport size

photograph

with Attestation

Periyar Nagar, Vallam Thanjavur - 613 403, Tamil Nadu, IndiaPhone: +91 - 4362 - 264600 Fax: +91- 4362 - 264660Email: [email protected] Web: http://www.pmu.edu

8/8/2019 PhD MS App10


10. Community : General/ OBC/ SC/ ST

11. Caste :

12. Mother Tongue :

13. Occupation of i. Father / Guardian :

ii. Mother :

14. Monthly Income of Parent / Guardian :

15. Do you need Accommodation in the

University Hostel? : YES / NO

16. Differently Abled : YES / NO(If yes, State the Nature with percentage

of disabilities along with an attested copyof medical certificate issued by a registered

medical practitioner, not below the rank

of civil surgeon)

17. Are you a sponsored candidate? : YES / NO

(If yes, attach the sponsored certificate)

18.a. Details of Academic Record (from degree level):

Qualifying

Degree

Specialisation Name of the

College/

Institution

University Month &

Year of

Passing

Average % of

Marks/Grade*

* Average % must be based on Marks/ Grade obtained in all the Semester examinations

b. GATE / UGC / CSIR / Other Score and Year of appearance :

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19. Professional Experience (Research / Industrial) If any, after the Qualifying Degree

Sl.

No.

Name of the

Organization

Designation &

Nature of Work

Period

From To

20. If employed

a) Regular / Temporary _____________________________

b) Name of the Employer _____________________________

c) Nature of work (Teaching / Industry/Other) _____________________________

d) Total Experience in years _____________________________

21. Details of Papers Published in refereed

Journals / Proceedings of Seminars / Conferences (Please add separate sheet, if needed) :

22. Any other relevant information :

DECLARATION BY THE APPLICANT

I …………………………………..(Name in full) Daughter /Son of ……………………. hereby

solemnly declare that the information furnished and the statements given in the application and

enclosures are correct and complete. I further declare that if it found otherwise, I will be liable to

forfeit my admittance and / or removal from the roll of the University whatever stage of study I may

be, besides criminal prosecution.

Place:

Date :

Signature of the Candidate

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SPONSORSHIP CERTIFICATE

(From the Present Employer)

Certified that Mr./Ms./Mrs. …………………………………………………………… is a permanent

employee of ………………………………………………………………… and is working as

……………………………………….. He/She is sponsored for the M.Phil / Ph.D. Programme

……………………………………… (Full Time/ Part Time) and all facilities will be extended tohim/her during the course of study.

This Organization/Department has no objection in permitting him/her to undergo the programme.

He/She has practical experience in this Organization/College for ………………….. year/s………………… months and ………….. days as on ………………….. as detailed below.

Sl. No. Designation Period of Service Duration of Service

From To Years Months Days

Total

Station: Signature of the sponsoring Authority

Date & Office Seal: Name & Designation

This certificate will not be valid if the Office Seal of the issuing authority is not affixed.

The application of the candidates who have not furnished the sponsorship certificate in theabove format will be rejected without any further communication.

If the above certificate is false or contains false information, criminal/legal action will beinitiated on the candidate and the concerned.

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NAAC ACCREDITED

PMU Entrance Test – 2010 (Research)HALL Ticket (Duplicate)(To be retained by the Periyar Maniammai University)

Reg. No.

1. Name of the candidate : Ms./ Mr………………………………

(IN BLOCK LETTERS)

2. Date of Birth :

3. Name of the Father / Guardian :

4. Address for Communication :with Phone number and e-mail ID

5. Personal Identification Marks : 1.

2.

6. Examination Passed / Appeared :

6.a. Registration No for the above Exam :

7. Choice of Entrance Test Centre 1…………………………

(Allotment depends on the response) : 2…………………………

3…………………………

8. Demand Draft Details :

Place:

Date: Signature of the Candidate-------------------------------------------------------------------------------------------------------------------------------------------

NAAC ACCREDITED

Reg. No……………..

1. Name of the candidate : Ms./ Mr……………………………

(IN BLOCK LETTERS)

2. Date of Birth :

3. Name of the Father / Guardian :

4. Personal Identification Marks : 1.

2.

5. Centre allotted for Entrance Test :

RecentPassport SizePhotograph

withAttestation

RecentPassport SizePhotograph

withAttestation

Signature of the Candidate

Authorised signatory of

Periyar Maniammai University

with seal

Periyar Nagar, Vallam Thanjavur - 613 403, Tamil Nadu, IndiaPhone: +91 - 4362 - 264600 Fax: +91- 4362 - 264660Email: [email protected] Web:www.pmu.edu

ADMISSIONS: 2010-2011

PMU Entrance Test - 2010

(Research)

HALL TICKET

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Qualifying Examination and Eligibility Criteria

Relevant P.G programme with good academic performance

2.Other State candidates

Candidates other than Tamil nadu are also eligible for admission to M.Phil and Ph.D

programmes. They should furnish the Nativity Certificate and migration certificate issued by

the competent authority.

3. Instructions for filling up the application form

a) If a candidate wishes to apply for more than one course, she/he should use separate

application form for each course. Only one course will be considered for one application

form.

b) Serial Number 1, 2, 3, 4, 5, 6, 7, 8, 11, 12, 14, 15, 19, 20, 21, 22, and 23 are self-explanatory.

Serial number 9 Nationality: Mention Indian or others

Serial number 10, 15,16, & 17: Mark () just above the appropriate category

4. The overall rank and community wise rank list will be published in the University Website,

www.pmu.edu. only.

5. Application form can be down loaded from the University web site www.pmu.edu or

obtained from University Admission office. Duly filled in application should be sent along

with a bank challan for Rs.750/- (For SC/ST Candidates Rs.500).

6. Attested copies of the following testimonials should be enclosed with the application form.

1. S.S.L.C Mark sheet

2. HSC mark sheet

3. Degree mark sheet

4. Transfer Certificate5. Community certificate

6. Citizenship (Family card issued by Civil supply office)

7. Sports, NCC, and other co- and extra curricular activities

8. Medical fitness certificate and Blood group certificate9. Passport size Photos – 5 Nos.

7. Those who have appeared for final examinations and awaiting for results can also apply.

8. Completed Application form should be addressed to

The RegistrarPeriyar Maniammai University

Periyar Nagar, Vallam, Thanjavur- 613 403,

Tamil Nadu, India

9. Last date for submission of Application: 18.06.2010.

http://www.pmu.edu/

http://www.pmu.edu/

http://www.pmu.edu/

PhD MS App10

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