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VINAYAKA MISSIONS UNIVERSITY , SALEM, TAMILNADU(Declared Under section 3 of the U.G.C Act, 1956)

M.Phil (Nursing) Degree Course

M.Phil (Nursing)

Duration :Full Time - 1 Year ; Part Time : 2 Years

ELIGI BILITY:

A pass in M.Sc (Nursing), Degree from the recognised Universtiy with 55% marks and above in aggregate or

equivalent.

Application form can be obtained:> By sending a DD for Rs.1100/- drawn in favour of VINAYAKA MISSIONS UNIVERSITY, payable at Salem

along with a request letter giving complete address and the course name.

> By downloading from the website: www. vinayakamission.com and sending along with a DD for Rs. 1000/-

> By paying cash for Rs. 1000/- in person at any one of the following addresses

For fur ther details contact us at the foll owi ng addresses

The duly filled in application form should be submitted to the following address.

THE REGISTRAR,VINAYAKA MISSIONS UNIVERSITY,Sankari Main Road (NH-47), Ariyanoor,

Salem - 636 308. Tamilnadu, India.Cell: 09362128685, 09344912553, 09362003194

Ph: 0427 - 3987000,2477316 / 317.Fax: 0427 - 2477903 .

THE REGISTRAR,

VINAYAKA MISSIONS UNIVERSITY,Sankari Main Road (NH-47), Ariyanoor,

Salem - 636 308. Tamilnadu, India.

ADMISSION CELL,

VINAYAKA MISSIONS UNIVERSITY,15, Bank Street.

Kilpauk, Chennai- 600 010.TamilnaduCell: 09383555060, 09841096255

Ph: 044 - 26451002,42989006,42989000Fax: 044 - 26451006.

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1. DETAILS OF REMITTANCE :

(To be filled by the Candidate)

a. Name of the Bank / Branch :

b. Amount remitted :

a. Demand Draft Number :

b. Date of Issue :

2. PARTICULARS OF THE APPLICANT

a. Name of the Applicant :

(In Block letters)

b. Date of Birth / Age on the day of submitting application :

c. Residential address with Phone No. :

3. SERVICE PARTICULARS

a. Designation and Department in which Working :

b. Full address of the Institution : Pincode :

Telephone No. :

c. Service particulars

(Separate sheet may be attached giving details of date of :

first appointment and posts held and duration)

d. Field of Specialisation :

e. Teaching Experience after Post Graduation :

4. DETAILS OF QUALIFYING EXAMINATION PASSED BY THE CANDIDATE

FOR ADMISSION TO M.Phil :

(Certified xerox copies of all degrees to be enclosed)

VINAYAKA MISSIONS UNIVERSITY, SALEM.(Declared under section 3 of the UGC Act, 1956)

M.Phil. REGISTRATION APPLICATION FORM FULL/PART TIME

RESEARCH FELLOW

5. DETAILS OF COURSE APPLIED :

a. Name of the proposed department for conducting Research : Nursing

b. Has the Guide is recognized by this University :

Degree Awarded Name of the Institution University Year of Passing % of Marks

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c. Name of the proposed Institution for conducting : Vinayaka Missions

M.Phil. Degree (Full Address) Annapoorana College of Nursing

d. Memberships of National / International academic bodies : TNAI

(Separate sheet to be enclosed) Any other

6. CERTIFICATION

a. Guide / Supervisors remarks and consent. : Signature and Office Seal

b. Consent of the Head of the Institution for Permission to carry : Signature and Office Seal

out the Research work and to provide necessary facilities Head of the Institution where

the candidate is working

c. Consent of the Head of the Institution where candidate : Signature and Office Seal of

proposes to carry out his / her research work. (Course Work) PrincipalVMACON, Salem.

d. Consent of the Director of Medical Education (for teacher : Signature and Office Seal

candidates working in Govt. Institution

7. Details of certificates enclosed.

a. Name of the Certified Xerox Copies of the certificate enclosed : i.

ii.iii.

iv.

v.

vi.

vii.

viii.

b. Detail of Annexures enclosed. : i.

ii.

iii.

iv.

v.

(If full time candidate enclose Relieving Order)

The Particulars furnished in the application are true and correct. In case any particulars furnished in the

application are found to be incorrect, I agree to forefeit my admission no matter at what stage of the course I will

be in at any time.

PLACE :

DATE :SIGNATURE OF THE CANDIDATE