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IIT Indore PHD Application Form 2012
IIT Indore PHD Application Form 2012
)
Ph.: 0731-2438719, Fax: 0731-2364182 (for Basic Sciences & HSS)
PACL Campus: 113/2-B (Opp. to Veterinary College), Village Hernia Khedi, MHOW Road,
Indore 453 446 (M.P.) Ph.: 07324-240701 (for Engineering)
IIT Indore
1. Full Name in Capital Letters: (as mentioned in the qualifying degree certificate)
Type or Write Legibly in English Keep one block blank between the two words
(DD/MM/YYYY)
4. Sex (M/F)
5. Nationality
6. Contact details*:
(a) Address for Correspondence:
City:
Pin Code
State:
City:
Pin Code
State:
Mobile No
E-mail Address(s)
1)
2)
At present the Institute admits PhD students as Full Time categories of:
Full-Time Scholars CategoriesA. Teaching Assistantship (TA) #
B. Govt./ Semi-Govt. Fellowship Awardees (FA)
(CSIR, UGC, DAE, DBT, NBHM, Commonwealth, Nehru Memorial Doctoral Fellowship, etc.)
C. Foreign Scholars (FS) *
#
As per MHRD Directives, candidate selected under TA category cannot accept or hold any appointment paid or otherwise or receive
any emoluments, salary, stipend from any source during the tenure of TA ship. Hence, candidates selected as TA and having
employment with or without pay with any organization/institution/establishment/project etc. must leave the job and submit relieving
certificate before joining the Ph.D. programme under TA category.
Sponsored candidates have to submit letter of sponsorship based on Appendix I/ II/ III/ IV respectively depending on the category in
which you seek admission.
For Institute Fellowship i.e. Teaching Assistantship (Except students with ME/M.Tech./M.Phil degree) all candidates should have
qualified GATE or CSIR-JRF or CSIR -NET or UGC-JRF or UGC-NET.
8. Details of Educational Qualifications from Matriculation onwards
(Original Certificates should be produced at the time of interview)
Degree/
Branch/Subject
University/ Institute
Examination
Passed
Month &
Year of
Entering
Month &
Year of
Passing
% of
Marks or
CPI/CGPA
Class/
Division
9. Details of qualifying examination like GATE, CSIR-NET, UGC-NET, or any other equivalent examination
(Original Certificates should be produced at the time of interview)
Name of Examination Year of Passing Validity Period Number of Candidates Marks
AIR Rank
Score/Percentile
Appeared
Obtained
Designation
Date
From
Nature of Responsibilities
To
Year of submission
Name of the
supervisor
Title
13. Broad Area of Specialization in which intend to work in the PhD programme:
Referee 1
Referee 2
Name
Designation
Organization
Office Address
17. Declaration: I do hereby solemnly declare that the information given above is correct to the best of my knowledge and belief. I
am fully aware that I must submit attested copies of my qualifying degree certificate / final transcripts, failing which, my admission
will stand canceled. I am also aware that providing incorrect information in the application form can result in the cancellation of my
admission at any stage.
Place:
Please post ONLY the completed application form (no photocopies of certificates) to the following address
in an envelope (27 cm x 20 cm) without folding the application materials. The envelope should be marked
Application for Ph.D. admission in the Discipline of _________" and should be sent to the respective
Head, of School or the Concerned Faculty to the respective address (IET campus for School of Sciences
and School of HSS and PACL campus for the School of Engineering)
To,
The Head of School of -------------------- (or Concerned Faculty Name)
Indian Institute of Technology Indore
--------------------------------------------- (Address of the respective campus)
Indore, MP, India
Phone: 0731-2438719 (IET Campus); 0732-4240701 (PACL Campus)
Website: www.iiti.ac.in
IET Campus: IET-DAVV Campus, Khandwa Road, Indore 452 017 (M.P.)
Ph.: 0731-2438719, Fax: 0731-2364182 (for Basic Science & HSS)
PACL Campus: 113/2-B (Opp. Ti Veterinary College), Village Hernia Khedi, MHOW Road,
Indore 453 446 (M.P.) Ph.: 07324-240701 (for Engineering)
IIT Indore
Place: