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Application Format PHD Admission 2024 25 Jan May Semester

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SUSHOVAN DAS
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Application Format PHD Admission 2024 25 Jan May Semester

Uploaded by

SUSHOVAN DAS
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Application No.

(for Office Use Only)

NORTH EASTERN REGIONAL INSTITUTE OF


SCIENCE AND TECHNOLOGY Paste your
Application Form for Admission to Ph.D. Programme recent
2024-25 (January-May Semester) unattested
[Please read the instructions given in the information Brochure BEFORE you fill up the form] photograph
(Visit: http://www.nerist.ac.in for details)
Tick (√) the relevant box wherever provided
Full Time with Assistantship Employed Candidates (No Assistantship)
Source of Assistantship Sponsored (Full Time) Part- Time
INSTITUTE CSIR
M.Tech. Degree
OR
GATE Description Year GATE Score GATE Marks (%) Experience Experience
UGC NET
CATEGORY

………………… ………. ………… ……………. Years……….


Years………
UGC JRF

Tick whichever
GENERAL EWS OBC\ (NCL) SC ST PH
is applicable
Department/Centre
CHOICE

[Write here name of only one Department/ Centre


You are applying to]
Proposed Area of Research

Name (in CAPITAL)


Gender Male Female Transgender Date-of-Birth (dd/mm/yyyy)
[Tick whichever is applicable]
Father’s Name
PERSONAL

Mother’s Name
Address for
Correspondence
PIN : State
Email: Mobile No:
Permanent
Address
PIN: State
Email: Mobile No:

Qualifying Exam……………………………… Duration of the course (Years)…………………Discipline……………………..…………………………


QUALIFYING

Year of Passing…………… Name of University/ Institute ………………………..…………………..………………………………………………


DEGREE

Marks Obtained Max. Marks Marks Obtained Max. Marks

CGPA/ Year 1 Semester I ……………… …………… Semester II …………………….. ……………


Marks
Obtained Year 2 Semester I ………………… …………… Semester II ……………………… …………………
CGPA Secured out of OR Aggregate % of marks (of all years/semesters)

Details of Marks Secured in the Examinations other than qualifying examinations


Exam./ Degree Discipline Institute/ University Year of Passing % Marks/ CGPA Division

Matriculation
PREV. ACAD. REC.

10+2/ Equivalent

B.Sc./ BA/B.Tech
M.Tech/M.Sc/
MA/M.Com
Other (specify)

Page | 1
Experience (From date to date) Designation Organization with address

EXPERINCE (If any)

List of Publications (Attach Separate Sheet if required)

Application fee: Amount: Rs. DD/Banker’s Cheque No_______________Date_________________


PAYMENT

[Candidates are required to pay the application fee of ₹1500.00 ( One thousand and five hundred) only in the form of
Demand Draft /Banker’s Cheque drawn in favour of Director, NERIST and payable at SBI NERIST (Branch Code
18744) , Nirjuli Arunachal Pradesh-791109

Have you ever studied and discontinued your studies at NERIST? YES NO

If YES, give Roll Number and the particulars of the programme earlier attended and the
reason for discontinuation.
DECLARATION
I hereby declare that the information given by me in the Application is true, complete and correct to the best of my
knowledge and belief and that nothing has been concealed or distorted. If any point of time, I am found to have
concealed/distorted any information or given any false statement, my candidature shall liable to be summarily
rejected/terminated without further notice or compensation.

Date: _________________ (Signature of the candidate)

FOR DEPARTMENT/CENTER’S USE


(Recommendations/observations of the office)

The candidate may be provisionally admitted/not admitted subject to the following:

1. Submission of attested copies of the qualifying degree certificate and marks sheet showing the required % of
marks/CGPA.
2. Submission of proof from the University / Head of the institution of having appeared/passed in the qualifying
Degree Examination.
3. Submission of GATE Score Card/CSIR/NET award letter (in original).
4. Submission of relieving certificate from Employer by………….……………………….
5. Submission of an attested copy of SC/ST/OBC(NCL)/EWS/PwD certificate, as applicable.
6. Application Fee of Rs 1500/- vide DD/Banker’s Cheque No____________________ dtd _________________

Signature of HoD/HoC
Page | 2

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