Sl. No. Application form for Admission to Ph. D.

Programme

National Institute of Technology Meghalaya

(To be filled in by the candidate) Session 20__

Fix a Self-Attested Passport size Photograph

Draft No:__________ Date:________ for Rs.________ Drawn at:________________ Department/Centre to which Ph. D. admission is sought:___________________________ 1. Name of candidate (in block letter) 2. Father's name/Mother's name 3. Permanent address (in full) 4. Postal address (for communication) 5. Date of birth 6. Nationality 7. Category (Please tick ) 8. Gender (Please tick ) : : : : : : : SC/ ST/ OBC/ GEN/ PWD : Male / Female

9. Educational qualification HSLC onwards (enclose self-attested copies of all testimonials): Name of Examination Year Board/University Marks % Division/ / CGPA Class Subject(s)/ Specialization

10. Teaching/ Research experience: (Mention level of teaching-UG/ PG/ College/ Institute/ Courses taught/ Area of research - Separate sheet may be enclosed) 11. Tick the category of candidature sought: Full time/ Sponsored/ Part Time/ Project Staff

12. Seminar/ workshop/ conference attended: (Separate list may be enclosed) 13. If employed, details of employment: Organization Position Regular / Temp Duration Nature of duties

14. If employed, whether leave will be granted/ already granted: (No objection certificate from the employer to be enclosed) 15. Statement of Purpose indicating the area and type of research work proposed to be carried out: (Separate sheet may be enclosed) 16. Specialized training (if any): 17. Scholarship/fellowship awarded for research (if any): 18. If qualified in NET/GATE/Any Other, Please Specify: Test/ Exam:_________ Score/ Percentile:_____ Year: _____ (Enclose Certificate) Test/ Exam:_________ Score/ Percentile:_____ Year: _____ (Enclose Certificate)

19. List of publications (if any): 20. Hostel accommodation required? Yes/ No Declaration I certify that the information given above are correct/true to the best of my knowledge. If anything proves to be incorrect my admission may be cancelled. If admitted I shall abide by the Institute rules and regulations. Date: Place:

Signature of the candidate

For Office Use Only Verified by: Name__________________________ Signature_____________ Date: _________ Designation ____________

Recommended/Not Recommended:

Chairperson, Selection Committee Date:

(Format for Sponsorship Certificate on Official Letter Head) To, The Dean (Academic), NIT Meghalaya

Sub:

Sponsorship of Mr./Ms._______________________ for Ph. D. programme at NIT Meghalaya

Dear Sir/ Madam, Mr./Ms.______________________________ who has been working in this organization as __________________ is hereby sponsored for carrying out the Ph. D. work at NIT Meghalaya from the session _______________ as a full time scholar. The employee will be relieved from his/ her duties in the organization to join the Ph.D. programme.

Date: Place:

Signature: Name : Designation: Seal of Sponsoring Authority

(Format for No-Objection Certificate from Employer on Official Letter Head)

To, The Dean (Academic), NIT Meghalaya

Ref No: Date:

Sub: No objection certificate

Dear Sir/ Madam,

It is hereby certified that Mr./Ms._____________________ has been working in this organization as _________________. This organization has no objection to his/her being admitted to the Ph.D. programme at NIT Meghalaya from the session starting on _____________ as a part-time scholar. The employee will be relieved for his/her Ph. D. course work, examinations and other formalities of the Ph. D. programme of NIT Meghalaya. .

Date: Place:

Signature: Name: Designation: Seal of competent authority