SATHYABAMA
INSTITUTE OF SCIENCE AND TECHNOLOGY
(DEEMED TO BE UNIVERSITY )
Accredited with Grade “A” by NAAC
Jeppiaar Nagar, Rajiv Gandhi Salai, Chennai – 600 119, Tamil Nadu. India
CENTRE FOR RESEARCH
APPLICATION FORM
FOR RECOGNITION AS Ph.D. / M.Tech (By Research) SUPERVISOR
Eligibility Criteria:
- Faculty members working in Sathyabama University with minimum of one journal publication after obtaining the Ph.D. Degree are eligible to apply for this supervisor recognition.
Applying for the faculty of……………………………………………………………………….
1. Name (in Block Letters) :
2. Date of Birth :
3. Designation :
4. Address with Mobile / Phone No. & E-mail :
a) Official :
b) Residential :
5. Academic Background (Start with the latest Degree Obtained)
(Enclose copies of Degree/Diploma Certificates)
S.No. / Degree/Diploma / Year of Passing / University / Major Discipline6. Area of Specialization :
7. Professional Experience (Start from the present employment):
S.No. / Organization / Period / Designation / Nature ofjob
From / To
8. Membership in Professional Societies :
9. Number of Sponsored Research Projects
(AsPrincipalInvestigator: give details separately) :
10. Research Guidance (No. of Thesis guided) :
(a) M.Tech (By Research) :
(b) M.Phil. Thesis:
(c) Ph.D. Thesis :
11. Examiner for M.Tech (By Research) / Ph.D. Thesis :
(a) Number of the Thesis Evaluated :
(b) Name of the University / Universities :
12. Are you an approved Supervisor for M.Tech (By Research)
Ph.D. Programme of any other University / Universities :
13. Publications
(Please attach list of publications and reprint (s)
of at least two publication published during the
last 3 years in National / International Journals /
Refereed conference proceedings)
(a) Number of papers in Refereed Journals :
(i) National Journals :
(ii) International Journals :
b) Number of papers published in refereed
Conference proceedings :
14. The Demand draft for Rs.200/- (Rupees Two Hundred Only) may be drawn in favour of “Sathyabama University”payable at Chennai as processing fee and is to be enclosed with the filled in application form.
Demand Draft No……………..………Date:………………….. Issuing Branch………………………
Date: Signature of the Applicant
Place:
Date: Recommended / Forwarded
Signature of Head of the Institution /
Approved Research Centre /
Affiliated Colleges
(with seal)
Place:
Encl.:List of Publications / Reprints / Details of Patent(s) filed or obtained.
Other Information & Xerox copy of Ph.D. Degree certificate.
………………………………………………………………………………………………………………………………………………………
(Office Use)
Approved / Not Approved Authorized Signatory
Vice Chancellor
………………………………………………………………………………………………………………………………………………………
CHECK LIST OF APPLICATION FOR RECOGNITION AS Ph.D. SUPERVISOR
YES NO
1. UG Degree Certificate (Enclosed attested copy)
2. PG Degree Certificate (Enclosed attested copy)
3. Ph.D. Degree Certificate (Enclosed attested copy)
4. Service / Experience Certificate
5. Professional body details
6. List of Publication / Reprints / Patents
7. Demand Draft
Verified by
Director (Research)