SINGHANIA UNIVERSITY

(Established U/S 2 (f) of UGC Act 1956)

Narnaul-Singhania-Pilani Road, Pacheri Bar, Distt. Jhunjhunu (Raj)-333515, Phone No: 01593271005,271331 Fax No: 01593-271003, Tele/Fax:01593-271070, Mobile: 09352237951/52/53,
website:www.singhaniauniversity.com

Application Form for M.Phil / Ph.D Guideship

1.

Name of the guide and Designation

2.
3.

Date of birth and age

Permanent Address

:
:

( with pincode and phone number )

4.

Present Address
( with pincode and cell number )

e-mail ID

5.

Subject

6.

Qualification

Degree

Month and Year

Class

University

Remarks

of Award
6.1 Ph.D
6.2 M.Phil
6.3 PG

7. (a) UG Teaching Experience

S.No
Name and address of

Designation

No of years
From
To

Total

Designation

No of years
From
To

Total

the College / University

7.1
7.2
(b) PG Teaching Experience
S.No

Name and address of

the College / University

7.1
7.2

8. Research Experience :
8.1 No of Ph.Ds Awarded under your supervision
( List and Topics may be given in Annexure I )
8.2 No of M.Phil awarded
( List and Topics may be given in Annexure II )
8.3 No of Publications ( Annexure III )
8.4 No of Conferences / seminars / Work Shops
Attended ( Annexure IV )
The information given above are true to the best of my knowledge. I am willing to guide
Mr / Miss _____________________________ for his/her M.Phil / PhD course being the
selected subject ________________________________ for the registered term ___________________.
The rules and regulations of the University, concerning to the courses and relevant matters are fully
acceptable to me and will be abided.

Place :
Date :

Signature & Seal