MADURAI KAMARAJ UNIVERSITY
Madurai Kamaraj University – Application Form for Non-NET Ph.D. Fellowship Passport size photograph, attested by a Gazetted Officer MADURAI KAMARAJ UNIVERSITY (University with Potential for Excellence) Application form for the admission of Non-NET Ph.D., Fellowship in UGC-XII plan grant for University with Potential for Excellence Read the terms & conditions, thoroughly before filling up this application form. Application with incomplete details would not be considered. 1 NAME (IN BLOCK LETTERS) 2 Father’s/Mother’s/ Name 3 Date of Birth & Age as on 1-4-2015 4 Marital Status 5 Sex 6 Nationality 7 Address for Correspondence 8 City with PIN 9 State 10 Mobile No. 11 Email Address 12 Permanent Address City with PIN State 13 14 15 Are you belonging to SC/ST category? (if so, enclose certificate in support) Indicate the enclosure – Yes / No Caste and category as per Tamilnadu State Govt. Reservation Policy (OC/BC/MBC/SC/ST, etc) Indicate the enclosure of community certificate – Yes / No Are you belonging to Physically Handicapped Category? (if so, enclose the certificate) 1 Madurai Kamaraj University – Application Form for Non-NET Ph.D. Fellowship Particulars of Educational Qualifications starting with Under Graduate/Post-Graduate Examination and onward (Please enclose self attested Photocopies). 16 Exam Passed 17 Year University / College Subject Rank, if any Indicate your PG degree and Subject The School of Madurai Kamaraj University, in which you would like to carry out your Ph.D., if selected for this fellowship. Subject in which you would like to enrol for Ph.D.? (It must be the same or related to your PG degree as per the research guidelines of MKU) 18 19 20 Present position 21 Are you a registered Ph.D., candidate of MKU or any other University If yes, furnish the details 22 Details of any research scholarship or fellowship holding or held previously (provide the duration of the fellowship or scholarship, along with a copy of the award letter amount received per month and details of research work done) 23 Any other information relevant to the research work, which you may like to indicate with reference to your application 24 Indicate the city (first three choices in order), where you would prefer to take online exam: Probable centres are: Madurai, Chennai, Coimbatore, Trichy, Trivandrum, Delhi, Mumbai, Kolkotta, Hyderabad (however, shall be decided upon the number of applicants, their choices and other factors) Online Exam Centre - First Choice Online Exam Centre - Second Choice 25 Online Exam Centre - Third Choice Enclosures (Please tick) a) Post-Graduate degree and Mark statement. b) Under-Graduate degree and Mark statement. c) SC/ST/BC/ MBC/etc. Certificate. d) Passport size photograph e) Date of Birth Certificate. f) Fee details: Applications without the fee will not be considered 2 Madurai Kamaraj University – Application Form for Non-NET Ph.D. Fellowship g) Any other relevant certificate or document. Note: All certificate/degree/enclosures should be self attested. DECLARATION I hereby declare, aware and agree that 1. The particulars given in the form are correct. Any false information would enable me to cancel the fellowship at anytime, after the award of fellowship by the University. 2. In case I am selected for the fellowship, I shall abide by the terms and conditions of the award and Madurai Kamaraj University in all aspects. 3. If selected, I shall undertake to engage myself whole time for research work on the subject under the direction of the supervisor for the entire tenure of the fellowship and Ph.D. 4. Even after selection and admission, lack of progress or any form of anti-institutional action would lead to the cancellation of fellowship and Ph.D admission by the University 5. University has the rights to not to release any fellowship, while I have not paid research / hostel fee. 6. The release of fellowship would be as per the release from UGC and MKU will never disburse advance fellowship in any case. 7. The duration / tenure of the fellowship would be in accordance with the XII plan General Development Assistance Grant assistance sanctions and release. 8. The decision of the University for the award of fellowship shall be final and no further correspondence in this regard shall be entertained. 9. If selected, the candidates should submit application for Ph.D., registration form within 30 days, after joining in the School and failure would result in the cancellation / withhold of fellowship. 10. No TA/DA will be paid for attending the exam or interview. 11. All further communications by University would be through email and I have given the right email-id. 12. Admission to the hostel would be subject to the availability during the time of admission. 13. Regarding the selection of guides, the decision of admission monitoring committee shall be final. 14. The regulation of MKU Research committee shall be applicable in all the aspects related to registration and further continuation of Ph.D, etc. Date Name and Signature of the Applicant Candidates shall remit the application fee of Rs.500 prescribed by the University into the State Bank of India, Palkalai Nagar Branch, Madurai Kamaraj University, in Account No I or fee may be paid into the credit of SBI Power Jyoti Account of MKU Fee collection Account Number: 30983167593 in any of the branches of State Bank of India nearer to your place or send a Demand Draft drawn on any nationalized Bank in favour of “The Registrar, Madurai Kamaraj University”. For SC/ST candidates 25% of the fee is applicable i.e. Rs. 125. Selection of candidates would be based on NET pattern examination. Tamilnadu Government roster system would be followed for 125 Fellowship positions. Full-time registered Ph.D candidates of MKU Schools those registered on or after 1-6-2014 also can apply and compete, provided not availing any fellowship as on 1-4-2015. The 1) clear details with certificates of registration, 2) history of fellowships availed with photocopies of award letter, and 3) certificate indicating the lack of fellowship signed by the Candidate, Supervisor, Head of the Dept. and Chairperson should be enclosed. Duly filled application form along with other documents should be submitted to: The Registrar, Madurai Kamaraj University, Madurai – 625021, on or before Mar 16, 2015. 3 Madurai Kamaraj University – Application Form for Non-NET Ph.D. Fellowship MADURAI KAMARAJ UNIVERSITY Paste a passport size photograph & get attested by a Gazetted Officer (University with Potential for Excellence) Particulars of Applicant for Non-NET Ph.D., Fellowship in MKU - UGC-XII plan grant 1 NAME (IN BLOCK LETTERS) 2 Father’s/Mother’s/ Name 3 Date of Birth 5 PG Degree & Subject 6 (a) Address for Correspondence 7 City with PIN & State 8 Mobile No. & Email Address 9 Application No. & Subject (To be filled by MKU office) 10 Sex Examination Centre & Date (To be filled by MKU office) Signature of the Applicant Signature of the Gazetted officer certifying the Photo identity with seal MADURAI KAMARAJ UNIVERSITY Paste a passport size photograph & get attested by a Gazetted Officer (University with Potential for Excellence) Particulars of Applicant for Non-NET Ph.D., Fellowship in MKU - UGC-XII plan grant 1 NAME (IN BLOCK LETTERS) 2 Father’s/Mother’s/ Name 3 Date of Birth 5 PG Degree & Subject 6 (a) Address for Correspondence 7 City with PIN & State 8 Mobile No. & Email Address 9 Application No. & Subject (To be filled by MKU office) 10 Sex Examination Centre & Date (To be filled by MKU office) Signature of the Applicant Signature of the Gazetted officer certifying the Photo identity with seal 4
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