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Application form for Entrance Test for Admission in Ph.D. Programme Paste Recent Self
attested
Photograph
Please read the Ordinance No.11 for Ph.D. and instructions given on the Portal before you fill up the form. Tick
() the relevant box wherever provided. Attach attested copies of certificates/mark sheet in support of following
information.
Branch/Subject:
At Graduation_____________________________________
Electronics and Communication
At Post Graduation__________________________________
Microwave and Millimeter Waves
Electronics Engg
Faculty Applied for :_______________________________________Subject _________________________ (As per Annex. A)
Interdisciplinary (If yes, Name other Faculty)____________________________Subject_________________(As per Annex. A)
(Fill separate forms for each Department, In case of Interdisciplinary, form should be filled in main faculty only)
Proposed Research Area (Board Area)_____________________________________________________________________
(Enclose Brief description of proposed work In 50 words) (Attach Separate Sheet)
Rajat Rusia
Name (in capital)____________________________________________________________________________________
Fathers/Husbands Name_____________________________________________________________________________
Late. Shri Madan Gopal Rusia
Gender Male Female Date of Birth : Date 14 Month Dec Year 1986
Category : Gen SC ST OBC
Mothers Name ______________________________________________________________________________________
Smt. Chhaya Rusia
39, Surya Nagar, Behind Kamla Nagar Police Station, Kotra , Bhopal
Address for Correspondence___________________________________________________________________________
____________________________________________________________________________________________________
rajatrusia@gmail.com Bhopal Madhya Pradesh
Email ID_______________________________City__________________________State____________________________
07554259100
Tel No with STD Code__________________________ 9893486842
Mobile No________________________________________
39, Surya Nagar, Behind Kamla Nagar Police Station, Kotra , Bhopal
Permanent Address____________________________________________________________________________________
Tel No. with STD Code 07554259100
M.Tech
Qualifying Exam _____________________________________________________________(attach copy of Degree)
Microwave and Millimeter wave
Discipline_____________________________________________________ 03 Years
Duration of Course (Years)________________
Name of University /Institute____________________________________________________________________________
Barkatullah University Institue of Technology, Bhopal
2015
Year of Passing _____________________________
CGPA/Marks obtained in qualifying degree ______________________Max Marks________________ %age____________
(M.Tech./M. Pharm/MCA/M.Sc./M.Arch.)
GATE/NET/SLET/GPAT or any other equivalent Exam passed.
Name of Exam____________________________________
Year of passing _______________ Marks obtained _____________________All India Rank _________________________
B.Sc.
B.Pharm
B.Arch.
Any Other
Experiences
Organization Designation From To Enclo. No.
Names and addresses of two references those are familiar with your academic
background.
Address__________________________________________ Address_____________________________________
City_____________________________________________ City________________________________________
Payment Details: (Demand Draft of j750/- in favor of Registrar RGPV payable at Bhopal)
DD Number Bank Date Issued Branch
Declaration
a) I declare that all the information given by me in this application form is correct to the best of my knowledge
and belief,
and I understand that false of incomplete information would cause invalidation of the application.
b) I shall abide by the decision of Rajiv Gandhi Proudyogiki Vishwavidyalaya, Bhopal in all matters pertaining to
admissions
in Ph.D. program. The decision on the university shall be final and binding on me.
c) I shall abide by the rules and regulations of the university and research center.
d) For all legal actions, suits and proceedings, the jurisdiction of court of law shall be deemed to lie exclusive at
Bhopal.
e) I have carefully read and understand ordinance 11 of the university for Ph.D. and I agreed to accept all terms,
conditions and
regulations.
f) I shall abide by the rules & Regulation as per Ph.D. advertisement and subsequent notification if any.
Signature of the
Candidate
N.B.:- All candidates applied for entrance test for the Ph.D. degree are requested to read carefully the
ordinance for Doctor of Philosophy of RGPV and to follow the provisions of the same.
List of approved Research Centres of RGPV for PhD research work.
I. Faculty of Biotechnology
1. Dr. Archana Tiwari, Prof. & Head Deptt. of Biotechnology, RGPV Bhopal
2. Dr. R.N. Shukla, Prof. & Head, Deptt. of Applied Chemistry, SGSITS, Indore
3. Dr. Shriram Prasad, Associate Professor, Chemical Engg. Deptt. MITS Gwalior
4. Dr. Sunita Sharma, Associate Professor, DoBT, MITS Gwalior
J. Faculty of Architecture
1. Dr. R.K. Pandit, Prof., MITS, Gwalior
K. Faculty of Pharmacy
1. Dr. Deepti Jain, Professor & Head, SoPS, RGPV, Bhopal
2. Dr. T.R. Saini, Prof .SGSITS Indore
3. Dr. Meena Tiwari, Professor, SGSITS Indore
4. Dr. R.K. Maheshwari, Prof. & Head, SGSITS Indore
5. Dr. Neha Kawathekar, Asso. Prof.& Head, SGSITS Indore
L. Faculty of Chemical Engg.
1. Dr. J.K. Shrivastava, Prof. & Head Deptt. of Chemical Engg., UEC, Ujjain
2. Dr. Kanjan Upadhyay, Deptt. of Chemical Engg., UEC, Ujjain
3. Dr. A.K. Sharma, Reader Deptt. of Chemical Engg., UEC Ujjain