Dr. NTR UNIVERSITY OF HEALTH SCIENCES::AP::VIJAYAWADA 8 REGN. No:_____________ APPLICATION FOR Ph.D.

REGISTRATION (FULL TIME/PART TIME)

Affix self attested passport size photogr

1. Name Of The Candidate (In Full) 2. Fathers Name 3. Date Of Birth 4. Address For Correspondence

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4.a) Mobile/Residence Telephone with STD code No. of the candidate 4.b) E-mail ID of the candidate

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5. Educational Qualifications (Degree, Post Graduate & Specialty)

6. a) Name and Address of the Research Guide b) Date of Birth of Guide 7. Department and College/ Institute where research will be conducted 8. Whether the Research Guide is recognized for Ph.D by Dr. NTR UHS. If so, the letter No.and date of recognition letter

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-29. Name and address of the Co-Guide, if any :

10. Whether the research will be carried out Full time/part time 11. a. Subject/ Specialty of Research b. Topic of Research (Enclose detailed plan of research with time frame along with ethical clearance) 12. Whether any Financial Support is available for Ph. D work 13. Signature of the candidate 14. Signature of the Research Guide 15. Signature of the Co-guide 16. Signature of the Head of the Department 17. Signature of the Principal of the college/ Head of the Institution (With Seal)

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18. Enclose Application fee of Rs.1000/-(Rupees One Thousand Only) by way of DD drawn in favour of the Registrar, Dr. NTR UHS payable at Vijayawada on any Nationalized bank and two passport size photographs along with the attested copies of academic credentials . NOTE: INCOMPLETE APPLICATIONS ARE LIABLE FOR REJECTION. This application can be downloaded from the website of the University http://ntruhs.ap.nic.in and the print out of the filled in applications will be submitted to the Registrar, Dr.NTR University of Health Sciences, Vijayawada on or before 25-6-2011.