DRAFT_Applicatin form - Centre for Studies in Social Sciences ...

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DRAFT_Applicatin form - Centre for Studies in Social Sciences ...

CENTRE FOR STUDIES IN SOCIAL SCIENCES, CALCUTTAR-1, BAISHNMABGHATA PATULI TOWNSHIPKOLKATA: 700094Affix a recentpassport sizephotographduly signed bythe applicantToThe RegistrarCentre For Studies in Social Sciences, CalcuttaKolkata-700094SIR,Form of Application forDOCTORAL PROGRAMME 2011I hereby desire to apply for the Ph.D. Programme and submit below the requisite details. If accepted,I shall abide by the rules and regulations of the Centre. Particulars given below are true and correct tothe best of my knowledge and belief.1. NAME (IN BLOCK LETTERS) ………………………………………………………(According to the school leaving certificate)2. DATE OF BIRTH …………….... SEX ……… MARITAL STATUS………………...3. FATHER’S NAME ……………………………………………………………………..4. MOTHER’S NAME …………………………………………………………………….5. CASTE: GENERAL/SC/ST/OBC/PHYSICALLY DISABLED ……………………….(Strike out which is not applicable and enclose relevant documents).6. NATIONALITY ……………………………7. PERMANENT ADDRESS …………………………………………………………………..………………………………………………………………………………………………….8. ADDRESS FOR COMMUNICATION ……………………………………………………...………………………………………………………………………………………………..9. TELEPHONE/ MOBILE NUMBER/ E-MAIL ID…………………………………………….


10. PARTICULARS OF ACADEMIC CAREER:Name of theExaminationSchoolLeaving/Secondary/ICSE/CBSE10+2/HigherSecondaryExaminationpassedName ofInstitute/UniversitySubjects/PapersYear ofPassingClass/Division(%) Marks/CGPAUndergraduatePostgraduateM.Phil. /NET/SET/RTP/TeacherFellowshipOtherQualifications(i)(ii)Attested copies of all Certificates and Mark sheet of Degrees etc. must be enclosed.Enclose relevant document if qualified for NET/SET/M.Phil./R.T.P./Teacher Fellowship.11. ARE YOU CURRENTLY ON A FELLOWSHIP/SCHOLARSHIP FOR PH.D./M.PHIL.RESEARCH?………………………………………………………………………………………………..12. ARE YOU CURRENTLY EMPLOYED? IF SO, PLEASE GIVE DETAILS :Organization served asJRF/SRF/Employee**Designation Period from and to Pay/Fellowship** Submit documents in support of your statement.


EMPLOYER’S CERTIFICATESri/Smt ………………………………………………………………………..is a full time/part timeemployee of this Organization/Institution/Industry working in the capacity of ……………………...…………………. We have no objection to his/her pursuing Ph.D. Research Work at the Centre ForStudies in Social Sciences, Calcutta as permitted under the rules.DATE : …………………..FULL SIGNATURE WITHDESIGNATION OF THE EMPLOYER WITHOFFICIAL SEALA C K N O W L E D G M E N E N TReceived an application form No ………………………………..From Shri/Smt…………………………………………………….For Ph.D. Programme 2011Date:Signature of Receiving Assistant & Seal

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