Scribd
Upload
18 views3 pages

PESU Application Form

The document is an application form for admission to PhD or MTech by research programs at PES University in Bangalore, India. It requests personal details from name, address and contact information to education qualifications, work experience, publications and other details to support the application. It also includes checkboxes for payment of fees and required documents to submit along with the application.

Uploaded by

Rohan G Raikar
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
Download as pdf or txt
18 views3 pages

PESU Application Form

The document is an application form for admission to PhD or MTech by research programs at PES University in Bangalore, India. It requests personal details from name, address and contact information to education qualifications, work experience, publications and other details to support the application. It also includes checkboxes for payment of fees and required documents to submit along with the application.

Uploaded by

Rohan G Raikar
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
Download as pdf or txt
Download as pdf or txt
You are on page 1/ 3

Paste recent passport

size photograph

PES UNIVERSITY
Bangalore 560085

Application form for Ph.D. / M.T ech by Research

1. Programme applying for: Ph.D. / M.Tech by Research

2. Mode: Full-time / Internal Part-time / External Part-time / Others (NRI/PIO/FN)

3. Faculty Applied for: Engineering / Management / Science / Computer Applications / Commerce


4. Proposed Department / Discipline: Civil / Mech / Electrical / Electronics/ Computer Science/ BioTech / Management/
Sciences (Physics / Chemistry / Math) / Computer Applications / Commerce
5. Proposed Research Supervisor, if identified:

6. Application Fee Details: on-line payment or D.D. for Rs.1050/- No.:……………….Drawn on


Bank……..……………….date:…………………….. in favor of “PES UNIVERSITY GENERAL FUND”

7. PERSONAL DATA
Name (in block letters) First: Middle: Last:
Whether employed Yes / No Name and address of
Employer
Date of Birth (DD/MM/YYYY) Place of Birth
Gender Male/Female
Father’s Name Mother’s Name
Category GM, SC, ST, CAT-I,
Physically Challenged,
Others
Residential Address Office Address Address for Correspondence

Email id Phone/ Mobile no.


Nationality State of Domicile
Religion

8. UGC/UGC-CSIR JRF/SLET/CAT/GATE/NET/GRE or any other National Test with valid score, other fellowship
exam details

Exam Name Exam discipline Score / Rank Exam Year

9. Academic Qualification
Programme Degree University Regular / Specialization % Marks CGPA Class Year of
obtained Distance passing
UG
PG
M.Phil
Others if
any
10. No. of years of experience: Industry: Teaching: Research:

11. Experience details

Dates (from-to) Employer Position Nature of Work

12. Number of Journal papers: Patents: Awards:

13. Did you apply previously? Yes/no, if yes give details

14. Names and addresses of three referees from whom letters of reference have been obtained

1.

2.

3.

15. No Objection Certificate of the Organisation

This is to certify that Mr./Ms. ……………………… is an employee of this Organization and the Organization has no
objection in recommending his/her candidature for admission to Ph.D./ M.Tech by Research / M. Phil. at PES
University on part-time / full-time basis. The information provided by the candidate is found correct as per our
records.

Authorized Signatory with Seal.


16. Enclose attested copies of the following, before sending the application :
Statement of purpose Any other additional Certificates supporting your claim
for benefits like:

10th / 12th or PUC / UG / PG degree Certificates and Marks ▪ Medical Certificate for the degree of disability in
cards of the Candidate support of candidates claiming benefit

Experience certificate, if applicable ▪ Test Score Card along with Admission ticket in
support of clearance of UGC/UGC-CSIR
JRF/SLET/CAT/GATE/NET/GRE or any other
Category certificate of candidates belonging to SC/ST/Cat- National Test with valid score
I/ and any other if applicable
▪ In case of candidate possessing degree from
Sponsor certificate, if applicable foreign Universities, The Equivalence Certificate
issued by the Association of Indian Universities
List of journal publications / patents, if applicable (AIU)

Proof of on-line payment or Demand Draft of Rs. 1050/- ▪ Passport with student Visa in the case of foreign
drawn in favor of “PES University General Fund” towards candidates
Application and Processing fee

17. Declaration by the Candidate

I ……………………………………………………………hereby declare that all the information given by me


is true to the best of my knowledge and belief. I understand that in the event of any information being found
incorrect or misleading, my candidature shall be liable to be cancelled by the University at any time and I shall
not be entitled to any refund of fees paid by me to the University.

Date: Signature of the Candidate


Place:

Visit www.pes.edu for details

You might also like