Application form for Ph.D.

  
Instructions
1. Please bring original and attested copies of the degree certificate/ marksheet(s)/experience certificates at the time of interview
2. Filling of false information may lead to cancellation of admission
3. Tick (√) the relevant box wherever provided
4. An application which is incomplete in any respect is liable to be rejected
5. Kindly send updated cv to studentcoordinatortdnbc@teri.res.in

Name*
Gender* Male Female Third Gender
Category
Date of Birth in School leaving certificate*
Nationality*
Father's Name*
Mother's Name*
Blood Group*
Full Address*



Mobile no*
E-mail* Alternate Contact no:

ACADEMIC RECORD

Name of the qualifying examination: (M.Tech./M.Sc./M.A./B.Tech. etc)*
Duration of the course
Year of passing
Discipline *
Name of the University/Institute *

Details of Marks/GPA/CGPA secured in the qualifying examination

Exam Passed/Appeared I Semester II Semester
I Year
II Year
III Year
IV Year
Maximum marks of all the years/semesters
Marks secured
Aggregate % of marks (of all the years/semesters)
Total
NB: In case where semester system is not followed, the marks should be indicated in the first part against each year.

# If the programme is not completed, indicate the aggregate marks/grade point obtained so far.

Details of marks secured in the examinations other than qualifying examinations

Main subjects Institute/University Year of passing % of marks/CGPA
10+2
B.Sc.
M.Sc./M.A.
B. Tech
Others (specify)

Relevant examination

a. IELTS Appeared   Qualified   To Be Appeared
Reading
Listening
Speaking
Writing
Total Band Score(Candidates should have valid IELTS scores before 1'st December,201)
Year appeared
b. GATE Appeared   Qualified
c. CSIR-UGC: JRF/LS/SRF Appeared   Qualified
d. ARS NET Appeared   Qualified
Percentile/Other score :
Discipline chosen in GATE / NET
Awards and scholarships received (if any)

Please fill in the following

1. Your Research Interest ( Maximum 150 words) *

Two referees who are familiar with your academic background and their addresses (Please provide their official contact number and email id) *
a.
b.

EMPLOYMENT RECORD:

Name of Employer(s) Period of Employment Designation & Salary Nature of Duties
Any other relevant information, which you want to furnish
Upload photograph*

You are required to upload a recent scanned/ digital passport size photograph of yourself (with White background).
Size : 2.5 cm x 3.5 cm and less than 100 KB (Formats -> .JPG, .JPEG, .GIF, .TIFF)
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DECLARATION BY THE APPLICANT:
Submission of this form is construed that he/she abides by the declaration. If selected for admission, I undertake to abide by the rules and regulations of TDNBC. I certify that the information given above is correct and I am aware that providing incorrect information in the application form may result in the cancellation of admission secured. I am further aware that, if the admission is secured before the results for the qualifying examination are published and if I fail to satisfy the minimum academic requirement for admission when such results become available, the admission will be cancelled.