RAYALASEEMA UNIVERSITY

RAYALASEEMA UNIVERSITY(A State University Established by Govt. of A.P)KURNOOL - 518 002 (A.P), INDIA.Application For Ph.D./ M.Phil (PART TIME / EXTRAMURAL)(Registration of Part Time and Extramural Research Programs are made round the year)Details of fee depositedDraft/ReceiptNo.………………….……………………………Dated:Signature of the AccountantApplication Rejected due to1…………………..........2………………………..3………………….........Signature of the AuthorityPASTE YOURLATESTPASSPORT SIZEPHOTOGRAPH(DO NOT PIN)APPLICANT’S BACKGROUND INFORMATION1. Name of Applicant (In Block Letters): ...........................................................................................2. Sex : Male ( ) Female ( )3. Father’s/ Husband’s /Guardian’s Name: ….…………………………………………………………..4. Occupation of the Applicant: ……………………………………………………………………………5. Occupation of Father/Husband/Guardian: ……………………………………………………………6. Present Designation: ……………………………………………………………………………………7. Present Office Address: ……………………………………………………………………………………………………………………………………..Dist. ……………………… State …………………..Phones (I) Land…………………… (II) Cell……………………………. Fax………………………..E-mail……………………………………………………………………………………8. Address for correspondence ………………………………………………………………………………………………………………………………..Dist. ……………………… State …………………..Phones (I) Land…………………… (II) Cell……………………………. Fax………………………..E-mail……………………………………………………………………………………9. Date of Birth ……………………………10. Nationality: Indian / NRI / Foreign ……………………11. Caste/Class/Category with name : SC/ST/PH/BC(A,B,C,D) GEN ………………………………12. Domicile …………………………………………………………………………………………………13. Enrolment No. if already enrolled in RU: ……………………………………………………………

14. Educational Qualifications (Attach copies of Mark sheets and Certificates):2ExaminationpassedGraduationBoard / Univ. Subject Year Division % ofMarksM.A./M.Com./M.Sc.MBA/MCA/M.Tech.(Specify)M.Phil.Any Other15. Proposed topic of Ph.D/ M.Phil:. ………………………………………………………........16. Department / Subject: ………………………………………………………………………..17. Research Experience: ……………………………………………………………………….(Enclose Certificate)18. Teaching Experience: ………………………………………………………………………..(Enclose Certificate)19. Other Experience if any: ……………………………………………………………………..Place:Date:Signature of the applicant20. (a) Name of the Supervisor: ________________________________________(In Block letters)(b) Designation:(c) Official Address:(d)Telephone No.s:(e) Email:_________________________________________________________________________________________________________________________________________________________________I agree to supervise the research work of Mr./Mrs……………………………………………………………………………………………………... of the M.Phil/Ph.D. Degree.Proforma - A already submitted - Yes / No(If the guide is an approved Guide of Rayalaseema University, please attach aXerox copy of the approval letter)Date: Office seal Signature of Supervisor

3Note:1. The consent of the Guide is not mandatory. However University encouragesResearch Scholars to identify his own Research Guide which will facilitatequick registration. In Case the candidate unable to identify a guide, Universitywill facilitate the same at a later date.2. The prescribed fee of Rs.250/- towards the cost of the application in favour ofDirector, Research Studies, Rayalaseema University and fee of Rs.1000/-towards the registration fee in favour of Registrar, Rayalaseema Universityis to be submitted along with the Application form by the way of DemandDrafts payable at Kurnool.3. Please furnish details of Name (in block letters) with Mobile No. and the subjecton the back side of the Demand Drafts.Attach:1. Copies of mark sheets (PG onwards)2. Certificate of date of birth3. Migration certificate4. Six self addressed stamped speed post / Regd. Post paid envelops to ensureeffective delivery of communication.[If you affix only Rs.5/- stamps the office is not responsible for delivery. We havereceived many complaints about non receipt of the ordinary post]5. Proforma - A (Refer web site of RU) along with Bio – Data of the supervisor.