Cost of Application : Rs.1000/-

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Application No.

Ph.D. REGISTRATION FORM

Registration No.(To be allotted by the University)

1. Name of the Applicant

Bank Name:

5. Date of Birth 6. Blood Group

Male Female

8. Religion

9. Social Status SC/ST/MBC/BC/OBC/OC/PWD

2. Gender

3. Official Address for Correspondence (Do not repeat the Name)

4. Residential Address (Do not repeat the Name)

7. Nationality

Fill up the details in English in BLOCK LETTERS

Put mark wherever applicable

For Eligibility Criteria, please visit our website

Website: www.ametuniv.ac.in

(Under Sec. 3 of UGC Act 1956)

PIN Code

PIN Code

State

Country

Country

State

1

10. Mobile No.of the Candidate:

11. Email ID .................................................................................................................

Email : directorresearchoffice@ametuniv.ac.in

DD No :

Date :

Branch :

Demand Draft in favour of The Registrar, AMET University, Chennai

Category(Please Tick) a. Full Time b. Part-Time (Internal) c. Part-Time (External)

D D M M Y Y Y Y

PIN Code State

Sl.No. OrganizationPeriod

From To

Salary

Per MonthDesignation Nature of Job

14. Academic Background (Start with the latest Degree / Diploma obtained)

(Enclose copies of Degree/Diploma Certificates duly self attested)-Attach Separate Sheet if necessary

13. Salary received per month

Sl. No.Degree/

Diploma

Year of

Passing

University/

Institution

Major

Discipline

Percentage

of marks and

Class

obtained

Full-Time (or)

Part-Time(or)

Distance

Education

1.

1.

2.

2.

3.

3.

4.

4.

15. Professional Experience (Start from the present employment)-Attach Separate Sheet if necessary

16. Awards/Medals/Prizes and Honours conferred if any :

17. Major Area of Ph.D. Research

19. School & Department in which the candidate proposes to register

18. Tentative Topic on which the research is proposed to be conducted

2

12. Are you employed?

If yes, specify the Name and Address of the Employer

Yes No

Country

3Part-time Candidates (External) shall have a Supervisor/Guide recognized by AMET University

preferably or from other organizations and in addition, shall have a Research Coordinator at the

organization in which they are working(optional).

20. DECLARATION OF THE CANDIDATE

21. PART-TIME (External) REGISTRATION ONLY

CERTIFICATE FROM THE HEAD OF THE ORGANIZATION

This is to certify that the particulars given above, are true, correct and complete to the best of my

knowledge and belief.

Place:

Date: Signature of the candidate

i) The candidate will be permitted to be available at AMET University for fulfilling the residential

requirements, as per University Regulations.

ii) The required facilities at our University will be provided to the candidate for doing research.

iii) The candidate will be permitted to be available at AMET University, whenever required by the

Supervisor to have discussions with him, to attend to the prescribed course works, to conduct

experiments and to participate in Seminars/Conferences/Workshops/Symposias/Short Term

Courses etc...

Name of the Research Coordinator (Optional) :

Designation :

Signature of the Signature of the Head

Research Coordinator of the Organization

Place :

Date :

Seal of the Organization :

22. CONSENT OF THE SUPERVISOR / GUIDE

(i)SUPERVISOR / GUIDE

a. Name (in BLOCK LETTERS)

(i) Official Address (Do not repeat the Name)

b. Address for Communication

PIN Code State

Country

4(ii) Residential Address (Do not repeat the Name)

(iii) Contact Phone Number

a) Office (with STD Code)

b) Residence (with STD Code)

c) Mobile

PIN Code State

(iv) Email ID ................................................................

c) Whether the Supervisor / Guide has been recognized by

AMET University to guide research scholars :

If yes, University Reference No.

d) No. of Ph.D Scholars Supervising

* This list is to be provided only after getting the consent from the members mentioned above. If Area of Research,

Designation & Address are not provided, properly then University will fix the DC Members.

e) Panel of Names suggested for the Doctoral Committee (DC) Members* :(Attach Separate Sheet if

necessary) (At least six names, excluding Supervisor, Research Coordinator must be given by the

Supervisor / Guide out of six, three from academic institution and three from industry)

(i) As a Supervisor / Guide in AMET University :

(ii) As a Supervisor / Guide in other Universities :

(v) Website address if any .......................................................

Sl.

No.Name Designation

Official Address

with Pin Code

E-Mail & Mobile

number

Area of Specialization

Country

CERTIFIED that the details furnished above have been verified and found to be correct and I am

willing to supervise the candidates research work.

Place :

Date : Signature of the Supervisor

(ii) JOINT - SUPERVISOR (Optional)

23. CONSENT OF THE AMET UNIVERSITY SCHOOL / HEAD OF THE DEPARTMENT

24. RECOMMENDATION OF THE DIRECTOR-RESEARCH :

25. FORWARDED BY

26. APPROVAL OF THE VICE-CHANCELLOR

a. Name (in BLOCK LETTERS)

b. No. of Ph.D Scholars Supervising

CERTIFIED that I am willing to Supervise the candidates research work.

(i) As a Supervisor in AMET University :

(ii) As a Joint-Supervisor in AMET University :

(iii) As a Supervisor/Joint Supervisor in other Universities :

c) Whether the Joint-Supervisor has been recognized by

the AMET University to guide. :

If yes, University Reference No.

Place :

Date : Signature of the Joint-Supervisor

Consent of the AMET University School / Head of the Department in which the candidate works: Yes / No(For Part-Time (Internal) candidates only)

Place : Signature :Date :

Name :

School / Department : Seal

Admitted / Not Admitted for Provisional registration in the Ph.D Programme Full-Time / Part-Time

(Internal) / Part-Time(External).

DIRECTOR - RESEARCH

REGISTRAR

VICE-CHANCELLOR

NOTE:

1. Duration of the Ph.D. programme is Three years.

2. Monthly Fellowship / Stipend of Rs.8000/- will be given to the selected candidates for the

Full Time Ph.D programme with fellowship category candidates.

3. Completed Ph.D Registration form with enclosures and demand draft should be sent to

The Director - Research

AMET University,

135, East Coast Road,

Kanathur - 603 112

Chennai, India

Tel : 044 - 27472155 / 157 Fax : 044 - 27472804

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