2/17/2020

VISVESVARAYA TECHNOLOGICAL UNIVERSITY "Paste ( do not pin ) passport size

BELAGAVI, KARNATAKA photograph in this space and get it
APPLICATION FORM FOR Ph.D./ M.Sc.(Engg) by Research a ested by Principal / Head of College /
University last a ended or a Gaze ed
Officer"

Applica on Form No: 12475

Program Applied for Program Type Faculty Applied for Registration Type
Ph.D Part Time Engineering Fresh Registration

Name of the Candidate Father's/Husband Name

VENKATESH KAVIDIDEVI SRINIVAS KAVIDIDEVI

Date of Birth Aadhar No: Gender Category Physically challenged Nationality

20, Jan 1988 376261485613 Male GM No Indian

Academic Qualifica on
Category Name of the Name of the University Specializa on Marks/Grade Year of Pass
Degree /Branch

FullTime BSC Osmania University, Hyderabad Mathematics, Physics, Chemistry Marks: 64% 2008

FullTime MTECH Jawaharlal Nehru Technological University Hyderabad Computer Science And Engineering CGPA: 8.68 2019

FullTime MCA Osmania University Hyderabad Master Of Computer Applications Marks: 70% 2012

Department Test Center Region

Computer Science and Engineering Kalaburagi

Experience in years Number of achievments

Industry Teaching Research Research Papers Patents Awards

11 0 1 0 0 0

Applica on Processing Fee Details

Date of Birth Ref.No Date Bank

20, Jan 1988 DUC7216330 15, Feb 2020 State Bank of India

Enclose the attested photocopies of the following in the order specified below, before sending the application

1 Detailed Bio-data of the Candidate 5 In case the candidate is possessing degree from Foreign University, the Equivalence
Certificate issued by the Association of Indian Universities (AIU).

2 All degree Certificates and Marks cards of the Candidate. 6 Aadhaar Card (Photocopy)

3 Category certificate of candidates belonging to 7 Passport with Visa in the case of foreign candidates/ Research Supervisors.
SC/ST/Cat-I/ and any other as applicable.

4 Test Score Card along with Admission ticket in support 8 Medical Certificate in respect of disability claim.
of clearance of UGC-CSIR, JRF.

Declara on by the Candidate

I VENKATESH KAVIDIDEVI hereby cer fy that all the informa on given by me are true to the best of my knowledge. In the event of any informa on being found incorrect or
misleading, my candidature shall be liable to cancella on by the University at any me and I shall not be en tled for refund of any fee paid by me to the University.
I have carefully studied the regula ons governing the degree of Doctor of Philosophy (Ph.D.)-Amended 2017.

Date SIGNATURE OF THE CANDIDATE

Visit www.vtu.ac.in for Recognized Research Centres, Fee Structure and Syllabus for VTU- ETR.

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