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SATHYABAMA UNIVERSITY

(Established under Section 3 of the UGC Act, 1956)


Accredited with B++ Grade by NAAC
(A CHRISTIAN MINORITY INSTITUTION)
Jeppiaar Nagar, Rajiv Gandhi Road, Chennai 600 119, Tamilnadu. India.

CENTRE FOR RESEARCH


APPLICATION FORM
FOR RECOGNITION AS Ph.D. / M.Tech (By Research) SUPERVISOR

Attested
Photo copy

Eligibility Criteria:
Candidates those who have gained two years Teaching / Research experience with minimum of two journal
publications after obtaining the Ph.D. Degree are only eligible to apply for this supervisor recognition.
Faculty members working in Sathyabama University with minimum of one journal publication after obtaining
the Ph.D. Degree are eligible to apply for this supervisor recognition.
Applying for the faculty of.
1.

Name (in Block Letters)

2.

Date of Birth

3.

Designation

4.

Address with Mobile / Phone No. & E-mail

5.

b) Residential

Academic Background (Start with the latest Degree Obtained)


(Enclose copies of Degree/Diploma Certificates)
S.No.

6.

a) Official

Degree/Diploma

Area of Specialization

Year of Passing

University

Major Discipline

7.

Professional Experience (Start from the present employment):

S.No.

Organization

Period
From

8.

Membership in Professional Societies

9.

Number of Sponsored Research Projects

Designation
To

job

(As Principal Investigator: give details separately)

10. Research Guidance (No. of Thesis guided)

(a) M.Tech (By Research)

(b) M.Phil. Thesis

(c) Ph.D. Thesis

11. Examiner for M.Tech (By Research) / Ph.D. Thesis :


(a) Number of the Thesis Evaluated

(b) Name of the University / Universities

12. Are you an approved Supervisor for M.Tech (By Research)


Ph.D. Programme of any other University / Universities
13. Publications
(Please attach list of publications and reprint (s)
of at least two publication published during the
last 3 years in National / International Journals /
Refereed conference proceedings)

(a) Number of papers in Refereed Journals

(i) National Journals

(ii) International Journals

Nature of

b) Number of papers published in refereed


Conference proceedings

14. The Demand draft for Rs.200/- (Rupees Two Hundred Only) may be drawn in favour of Sathyabama
University payable at Chennai as processing fee and is to be enclosed with the filled in application form.
Demand Draft No.. Date:.. Issuing Branch

Date :

Signature of the Applicant

Place:

Date:

Recommended / Forwarded

Signature of Head of the Institution /


Approved Research Centre /
Affiliated Colleges
(with seal)
Place:
Encl.: List of Publications / Reprints / Details of Patent(s) filed or obtained.
Other Information & Xerox copy of Ph.D. Degree certificate.

(Office Use)

Approved / Not Approved

Authorized Signatory
Vice Chancellor

CHECK LIST OF APPLICATION FOR RECOGNITION AS Ph.D. SUPERVISOR

YES
1. UG Degree Certificate (Enclosed attested copy)
2. PG Degree Certificate (Enclosed attested copy)
3. Ph.D. Degree Certificate (Enclosed attested copy)
4. Service / Experience Certificate
5. Professional body details
6. List of Publication / Reprints / Patents
7. Demand Draft

Verify by

Address for Vice Chancellor

NO

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