Annexure I

TAMIL NADU PHYSICAL EDUCATION AND SPORTS UNIVERSITY

Chennai - 600127
Affix

APPLICATION FOR ADMISSION TO Ph.D. DEGREE PROGRAMME

Recent Passport
Size Photograph
of the applicant

(Kindly go through the Ph.D. Regulations before filling up the application form)

FULL TIME / PART - TIME

PART A
(To be filled by the Applicant)
Subject for Ph.D
1

Name of the
Applicant
[as entered in the
degree certificate]
(in capital letters)

: ___________________________________
In English :

In Tamil

Name of the Father

Name of the Mother

Sex

Date of Birth and Age

Nationality

Community

Religion

Address for Communication

Male/ Female
D

AGE

Indian / Foreign ____________

GT / BC / BC(M) / MBC / SC / SC(A)/ST

Hindu / Muslim / Christian / Others ________

Pin code
Phone
e mail
Mobile

;
:
:
:
`Page 1 of 8

9. Academic Qualifications:
Course
Major Subject

Board/
Institution /
University

Percentage Date/ Month

of Marks
and Year of
Passing

SSLC

HSC/PUC

Under
Graduate
Degree

Post
Graduate
Degree (s)

M.Phil.

UGC
Lectureship
Eligibility
Test/
SLET/SET

Any other
Relevant
Courses

`Page 2 of 8

10. Professional / Teaching Experience:

(Photo copy be enclosed)
Institution

From

To

Total
Subject (s)
Experience Taught

School

University
Department
/ College

Other
Recognised
Institutions

11
12

13

14

Awards, Medals, Prizes and Honours

achieved by the applicant
Whether the applicant has previously
registered for Ph.D. course etc., If so,
give details
Broad Theme /
Title of the proposed Research Topic
(In block letters)

Any other particulars the applicant would

like to present for the consideration of the
authorities with regard to admission.

:
:

:
`Page 3 of 8

15

Declaration by Full-Time Applicants

I declare that I am not working anywhere either on a Full-time or
Part-time basis.

Signature
Place :
Date :
16

Declaration by All Applicants

I declare that I will abide by the rules and regulations of Ph.D
programme of Tamil Nadu Physical Education and Sports University

Signature
Place :
Date :

PART B
(To be filled by the thesis Supervisor)
17

Name, Designation and Institution where the

Proposed research supervisor is employed :

Pin code :
Phone :
e mail
:
Mobile :
18

No. and date of this office communication

through which he / she is recognized as a
Supervisor for Ph.D. Programme
(Xerox copy of the communication
should be enclosed.)

19

Date of Birth of Supervisor

20

Date of Retirement of the Supervisor

21

Whether the candidate is related to the

supervisor, if so, furnish the nature of
relationship.

22

Supervisors comments about the suitability

of the applicant for research
:

`Page 4 of 8

23
S.No

Particulars of Ph.D. candidates already Registered under the Supervisor and

thesis not submitted in Tamil Nadu Physical Education and Sports University,
Chennai.
Name of the Candidate

Reg. No.

Date of
Registration

Full-time /
Part-time

`Page 5 of 8

24

S.
No

Particulars of Ph.D. candidates already Registered and thesis not submitted under
the Supervisor in other universities.
Full- time /
Name of the
Reg.
Date of
Name of the Candidate
University
No.
Registration Part-time

Declaration by the Supervisor

I _______________________________
do hereby certify that the
information made by me under S. Nos. 17 to 24 are true and correct to the best of my
knowledge and belief. Nothing is false and nothing is concealed in it.

Signature of the Supervisor

(Seal)
Note : The details in the above tables ( S.No 23 & 24) must be filled by the supervisor, if not
Application will be summarily rejected.
`Page 6 of 8

PART C
Remarks and Recommendations
Remarks and Recommendations of the Head of Institution where the candidate is
employed for permission to do research.
Applicants Name and Designation:
Remarks and Recommendations :

Head of the Institution

(Where the candidate is employed)
(Seal)

Remarks and Recommendations of the Head of the Department / Principal of

Approved Research Centre (Where the candidate is proposed to do Research)
Applicants Name and Designation:
Remarks and Recommendations :

Head of the Department / Principal

(Where the candidate is proposed to do Research)
(Seal)
Details of Payment
Amount : Rs : .
D.D. Number : ..
Bank

: ...................

Branch

: .......................

Dated : .

Place :.................

`Page 7 of 8

CHECKLIST FOR ADMISSION APPLICATION:

Attested photo copies of :
1. Birth Certificate / S.S.L.C. Certificate (For proof of age)
2. Community Certificate
3.. X std., HSC/UG/PG/M.Phil. Mark Statements and Convocation Certificates
4. Part-Time candidates: Experience /Service Certificate and No Objection Certificate
from the Head of the Institution where the candidate is employed indicating the date of
appointment , whether permanent or temporary or leave vacancy, contract etc should
be furnished.
5. If the above said required documents are not submitted along with the application
for Ph.D Admission the application will be summarily rejected.
INSTRUCTIONS
I. Part A should be filled by the applicant.
2. Part B should be filled by the thesis Supervisor.
3. Part C should be filled by the Head of the Institution (Where the candidate is
employed) and Head of the University department / Principal of Approved
Research Centre.
4. The candidates who are willing to do research in the Departments of this University
should sent the filled in application to the Director Research of this University on or
before 10th February or 10th August of every year or as per the University
notification.
5. The candidates who are willing to do research in the Approved Research Centres
should sent the filled in application to the / Principals of the Approved Research
Centres on or before 10th February or 10th August of every year as per the
University notification.
6. The original certificates must be produced for verification at the time of interview,
and if selected the original P.G Mark sheet , Experience/ Service and No
Objection certificates must be deposited in Research section (R3).
*****
`Page 8 of 8