MADURAI KAMARAJS UNIVERSITY (UNIVERSITY WITH POTENTIAL FOR EXCELLENCE) APPLICATION FOR RECOGNITION OF PERSONS AS GUIDE TO SUPERVISE PH.D REGISTRANTS APPLICATION FORM IS VALID UPTO THREE MONTHS FROM THE DATE OF ISSUE/DOWNLOAD ‘This form of application should be filled in by the applicant in his /her own handwriting, and forwarded to the Registrar, Madurai Kamaraj University, Madurai 625 021, through the Head, of the Department and Principal of the College / Institution concerned, Cai ai in ae ap oF For Office Use Only he photog Date oF ese Date of receipt: Affix passportsize photograph of | Name of Branch of SBI‘Rs,___ ates the candidate Name of Bank: Branch vate: No. Head of the institution should countersgn the photograph at the Signature bottom ‘The subject in which the applicant is secking guide recognition 1 [Name of the Applicant (as English entered in the office records) IN BLOCK. LETTERS Tamil 2 | Name of the Father / Husband 3 po wa [ wy | age | Place ofBinn a Date of Birth af Mate Date of Retirement Female 5 Community * Nationality Religion ‘oc/ Bc) MBCY ScrsT Address for Communication with Pin code 7 : Tandline wih For cadeNo immediate | e-mail address _ contact Mobile PhoneTustitution Whether Served | Designation | Whether | Subjects handled Gowt/Aided regular or Self employee! Financed Temporary/ contract basis From | To UG [PG] MPhil Total Teaching [UG PG __| MPhil experience Whether the subjects handled as provided in the above table are relevant to the subject chosen for recognition as a guide? Educational qualification Degree | UG PG MPhil, i, Branch / Subject College University ‘Moath and Year of Passing Class Grade / Division ‘Any Previous Guide Recognition | Yes 7 Partioulars* inthis or any other | No if Yos *Self attested Photocopy of the Order Issued by the University University must be attached 0 ‘Whether equivalency certificate is enclosed 2(Those who have obtained Ph.D degree in other Universities should produce the equivatency'certficate pertaining to this University along with this application) 7 Have you been a guide for PG Student? MPhil Project and if 0, produce details with evidences ‘Whetier your Department Institution has already been @ recognized research centre of this University for doing Ph.D research ? If so, produce evidence 3B Tfthe applicant is working in a UG Department, tate ‘whether the Depariment has adequate infrastructure facilities {o pursue Ph.D research, If so, evidences should be furnished ‘The subject in which the applicant has got Ph.D degree with topic and ttle ‘Nunber of yeats of Post Doctoral Experience (provide details indicating inland or abroad) “The subject in which the applicant is sedking guideshipWhether any minor /major research projects was /were sanctioned to the applicant by funding agencies like CSIR. IDST (DBT! UG/ ICSSR/ ICHRY ICPR/AICTE ete. If so, the details with evidence should be produced 18 | Papers present in National and International level with detailed list 19 | Total number of papers published (provide alist as annexure with a set of reprint) 20 | indicate which ofthe publication are relevant to the subject seeking forthe guideship recognition 21_| Seminars Attended, I's, Furnish details, 22_| Details of seminars conference or any other program ‘organized/ conducted in the subject relating the guideship recognition 22 | Broadcast ‘Telecast in T.V/Radio Talk relevant to research work 24 | Any other details relevant to this application ‘The application for Ph.D Guideship should be submitted with the pres * Strike out whichever is not applicable id fee of Rs. 1000/- with required documents. Applications received without evidence will summarily be rejected and the fee once paid will under no circumstance be refunded or held over for any subsequent similar applications / requests. Station : Date: SIGNATURE OF THE HEAD OF ‘THE DEPARTMENT (vith office seal) SIGNATURE OF THE APPLICANT SIGNATURE OF THE HEAD OFTHE DEPARTMENT OF THE UNIVERSITY / INSTITUTION/ EMPLOYER (with office seal)SERVICE CERTIFICATE This is to certify that Thiru/Tmty/Miss is working as in the Department of. from to under Permanent employee in the scale of UGC / Tamilnadu State Government . Signature, Head of the Institution/Employer (with office seal) Place: Date: Note: The above application form can be downloaded from www.mluresearchorgUn Bion ALUINO YL AP ELAU A LUI PUI LUGO, OF PERSONS AS GUIDE TO SUPERVISE PH.D REGISTRANTS IN MADURAI KAMARAJ UNIVERSITY Sl. Office No PARTICULARS é Remaris | _Use | T | Payment of Registration Fees Rs. 10007 & Yes /No 2_| whether to be submitted Original and Duplicated copy enclosed Yes/No ! [3] Those who have working in the Self Finance College/self supporting Yes/No courses/ scheme/project if any ia Aitested Copy of UG Degree Yes/No Attested Copy of PG Degree Yes/No i Attested Copy of UG & PG Mark Sheet Yes/No Aitested Copy of M.Phil Degree Yes/No Aitested Copy of Ph.D Degree Yes/No | Aitested Copy of any other Degree , if Yes Specify Yes/No Original employer Certificates to be submitted along with application * | Yes/No Aitested Copy of appointment order sent by the Instifution® Yes/No Recognition Certificate for M.A./ M.Sc/ M.Com., M.Ed and M.Phil., Ph.D. | Yes/No Degree.(Enclosed) 13 | Should be Enclosed Forwarded Copy / No Objection Certificate from the | Yes/No hhead of the institution / Employer/ University / others 14 | Photocopy of the recognition of research centre order issued by the | Yes/No Registrar, M-K. University, Madurai.* | 15 | Service Certificate from the head of the institution showing the details of | Yes/No Permanent Service in the Official format along with proof of scale of pay/ Pay slip etc., | 16 | Proof for the recognition of Institution / College in which you are working _| Yes/No TT | Teachers who are not from approved research centres Yes/No 18 | Publications relating to his/her Ph.D work Yes/No 7 | 19 | All Professors, Associate Professors and Assistant Professors with a Ph.D | Yes/No | degree working in the University Schools / Departments / Departments of | | DDE recognized for research and are currently engaged in research with ‘ovo years of research experience | 20 | Teachers of (PG/UG) Departments of affiliated colleges who are currently | Yes/No ‘engaged in research as shown by publications 21 | Two years of Research experience after the date of award of Ph.D., degree. | Yes/No Publications of their independent original research work (other than t Ph.D work) in refereed research journals and having a minimum of 5 years of teaching experience. 22 | Those who have carried out 2 Major or 3 Minor research projects sanctioned | Yes /No by government funding agencies like CSIR / DST / DBT/ UGC / ICSSR / ICPR/ ICIIR/ AICTE etc., are eligible to be recognized as guides 23 | Certified by the Head of the Institution that there are adequate infrastructure | Yes/No facil including laboratory space, equipments, internet etc. ‘+ Original employer Certificates to be submitted along with application for verification + Incomplete information /certificate will not be entertained Signature of the Candidate Signature of the Head of the Institution/Employer