Nirma University Admission Application Form - StudyChaCha

NIRMA UNIVERSITY
INSTITUTE OF TECHNOLOGY
Gandhinagar - Sarkhej Highway, Ahmedabad - 382481,
Gujarat – INDIA
Web downloaded
Demand Draft No. Dated of `1000/-
Drawn on:
is attached.
Last Date of submission of fill up application form: June 18, 2012
APPLICATION FORM
Ph.D. ADMISSION – 2012
Affix a recent
passport size
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Ph. D. PROGRAMME APPLIED FOR (PLEASE () ANY ONE)
Chemical Engineering
Electronics & Communication Engg.
Civil Engineering
Computer Science & Engineering
Instrumentation and Control Engg.
Mechanical Engineering
Electrical Engineering
PLEASE () ANY ONE Full Time External Sponsored
1. Name of Applicant
2. Address for the correspondence:
PIN
Tele. No.
E-mail ID
Mobile
3. Nationality 4. Date of Birth / / 5. Sex: M F
6. Details of Academic Record *
Examination
Passed
Major Branch Institute University Year of
passing
B. E./ B. Tech.
Marks
Obtained (%)
M.E. / M. Tech
Any other
7. GATE Score
GATE Exam Paper Marks out of 100 Score Year of Examination Score Valid up to
8. Research Experience* :
Name of University/
Institute/Industry
Period Position held Details of Research Work
* Add separate sheet if required
Ph. D Admission 2012
Page No.1

9. Details of papers published*:
Title of Dissertation /
topics of research /
paper published
Name of Journal, Volume, Page
No. etc.
Year of
Publication
Name of other authors
if jointly published
10. Other work experience - give details*
Organisation Position Part Time/
Held Full Time
Period
Type of
Experience
Salary Drawn and
scale of pay
11. Have you registered as Ph.D. Students elsewhere If yes give the following details
Name of the University ___________________________
Name of Guide/s_________________________________
Topic__________________________________________
Date of Registration ______________________________
12. Please write area (as mentioned in brochure) and three sub areas of your research interest in
order of preference in the area chosen by you
i)
ii)
iii)
Area :__________________________________
Topics (Sub Areas)
Declaration: I certify that the information given above is correct. I am aware that on providing
incorrect information in application form will result to the cancellation of my admission to the
Institute.
Place: Date: Signature of Applicant
* Add separate sheet if required
Ph. D Admission 2012
Page No.2

No Objection Certificate **
This is to certify that Mr./Ms.____________________________________ is working in
___________________________________ (Name of organization / Institute) as
_______________________ on full time basis and he/she is permitted to join the Ph. D. Programme
at Institute of Technology, Nirma University and he/she will be allowed to continue fulltime / external
till the completion of the programme.
Signature of authority with office seal
Instructions:
1. The web-downloaded form must be accompanied by a Demand Draft for ` 1000/- (nonrefundable)
in favour of "INSTITUTE OF TECHNOLOGY, NIRMA UNIVERSITY"
payable at Ahmedabad. Write candidate's complete name & programme / specialization
area applied for on backside of the Demand Draft.
2. List of certified copies to be attached are as under. Original documents should be
produced at the time of admission.
i. B. E. / B. Tech. and M. E / M. Tech., qualifying examination mark sheets and
certificate of passing.
ii. GATE Score Card, if applicable
iii. Certificate of research experience if any.
iv. Copies of technical papers published, if any.
v. Experience certificate, if applicable.
3. While considering the application the preference will be given to the candidates who
have passed the National Level Test like UGC / CSIR(JRF) examination / NET / SLET /
GATE / teacher fellowship holder, M. Phil, etc or its equivalent. Such candidates will not
be required to appear in the test conducted by the university.
4. If applicant has passed the qualifying examination from University other than Nirma
University he/she will be required to obtain eligibility certificate from Nirma University.
5. Duly filled in application form along with Demand Draft is to be sent, in a sealed
envelope marked as "Ph.D. ADMISSIONS 2012" on the left hand side top corner of the
envelop, to:
Member Secretary (PG-ENGG. Admission)
Postgraduate and Research Center, Institute of Technology, Nirma University
Gandhinagar-Sarkhej Highway Ahmedabad - 382481, Gujarat – INDIA
Tel: 02717 – 241911/12/13/14/15 ; Fax : 02717 241917
Email : pgadmissions.it@nirmauni.ac.in
________________________________________________________________________
** Only in case of candidate already in employment
Ph. D Admission 2012
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