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8/2/2019 Bits Pilani Phd.
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LAST DATE OF RECEIPT: 23rd MAY 2012 5.00 p.m.
Application No. PH _______________BIRLA INSTITUTE OF TECHNOLOGY & SCIENCE, PILANI, RAJASTHAN - 333 031
APPLICATION FOR ADMISSION TO PH.D. PROGRAMME
This is a downloaded application form. This should be attached to the registration confirmation page printed out by you after
registration at BITS website. Otherwise, this form is invalid. This form is only for Ph.D Aspirant candiddates
PART I
(Read instructions before filling. Tick ( ) the appropriate boxes and strike off options not applicable)
1. (a) Full Name (in Block Letters) ____________________________________________
(as given in your degree certificate)
(b) Date of Birth (dd/mm/yyyy) _____________ (c) Gender: Male Female
(d) Nationality: _______________________________
2. (a) Father's Name: ______________________ (b) Mother's Name: __________________
3. Phone No/.(with STD Code)/ Mobile No. _________________ Email: _________________________________
4. Institution last attended as a regular student and years: ____________________________________________
5. If you have ever been on the rolls of BITS, provide the latest ID No. ____________________
6. Employment record:
Period* Name & Address of the
Organisation
Designation Nature of Responsibility
From To
7. Academic Record: Details of all Degree/Diploma examinations passed, starting from High school/Higher secondary. (Enclose
photocopy of mark sheet and certificate of your qualifying degree)
Degrees/ Diploma Year of Passing
Duration ExaminingAuthority
Aggregatepercentage of
marks/ CGPA
Division Subjects/Discipline
Note: Candidates should account for all the years up-to-date. If there are any failures, gaps or discontinuity in the
educational career, they should be explained in a attached sheet.
8. Awards like Merit Scholarships, Gold Medal, NSTS, NTS, etc. that you have received:
______________________________________________________________________________________________
9. Have you taken any course(s) from the higher degree programme of BITS or equivalent as a part of your first degree
(B.E, MSc or equivalent) programme? Yes No
If your answer to 9 is 'yes', give the name of the courses(s), year, semester and the grade obtained.
1.________________________________________ 2. ______________________________________
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10. If you have done any BITS Higher degree or its equivalent (M.E., M.Pharm., M.S., M.Phil.,MBA etc.), give details:
(a) Name of the Degree___________________________________________________________________
(b) Name of the Institution ________________________________________________________________
(c) Duration: From _________ To __________ (d) Part-time or full-time? _____________________
(e) Name of courses and marks (%) or grades obtained (Attach syllabi of all courses, if degree is not of BITS).
S.No. Course Name Percentage
Marks/Grades
Prescribed Text Book
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11. If you have ever been a Ph.D. student,
(a) Name of the Institution _____________________________________________________________
(b) Duration: From ____________ To ______________
(c) Research topic and supervisor _______________________________________________________
(d) Fellowship (agency and amount) ______________________________________________________
(e) Reasons for discontinuing ___________________________________________________________
12. Have you ever appeared in a Ph.D. qualifying examination at BITS? Yes No
If yes, (a) ID No./Appl No. and Year ____________________ (b) Dates of Examination ___________________
(dd/mm/yyyy)
(c) Result Pass Fail
13. Attach separate sheets giving (i) details of Technical publications/patents (Give title, name(s) of the author(s) and journal in
which appeared) and (ii) Professional Attainments & Distinctions.
14. If you have applied to any other degree programme of BITS, give
Application No.: ______________ Degree programme: __________________
15. Give broad topic and out line of research you wish to pursue:
16. Declaration by father or guardian (or employer in case of sponsored candidates): I do solemnly affirm that I shall beresponsible for the discipline and conduct of my son/daughter/ward/employee and pay regularly all his/her expenses during
his/her stay in the Institute.
Place ____________________ Signature____________________
Date _________________________________ Name ___________________________
Designation ___________________________ Address (in case of employer) ___________________________
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_________________________________
17.Declaration by the Applicant: I hereby declare that the information given and statements made in this application and also in
its accompanying attachments and enclosures are true to the best of my knowledge. I agree to the condition that if any
information or any statement is found to be wrong, my admission to the Institute would automatically be cancelled.
If admitted, I promise to abide by the rules and regulations in force or those that may hereafter be made for the
administration of the Institution and I shall do nothing which will interfere with its orderly working and discipline. In all
matters concerning me and the institution, its hostel, Practice School stations, the decision of the Vice-chancellor shall be
binding on me.
Place ____________________ Signature____________________
Date _________________________________ Name ______________________________
Permanent Address:________________________ PSRN (applicable to BITS faculty only): ____________________________________
Enclosures relevant to Part I
(a) Proof of date of birth
(b) Photo copy Mark sheet and certificate of qualifying degree
(c) Syllabus of Higher degree courses, if holding a higher degree(d) Proof of employment
(e) Any other, specify ______________________________________
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Application No.: PH _______________
PART I ABSTRACT
(To be filled in by all candidates)
1. Name: ____________________________________________
2. Sex: Male/Female: ______________ 3. Age: _______ years
4. Academic Record:
Programme Division % marks Year of passing Board/Univ. Subjects/Discipline
10 +2
B.A./B.Sc.
B.E./B.Pharm/M.A./M.Sc.
M.E./M.S./M.Pharm.
Any other degree?
5. lf presently employed, give name of the Organisation: _______________________________________
Employed since when? ______________________________
6. Broad Topic of Research you wish to pursue:
7. Special competence and skills, if any?
8. If you have applied for any other degree programme of BITS, give
Application No.: _____________ Name of degree:___________________
9. Have you ever been a Ph.D. student at BITS? YES / NO ID No. (if yes): ____________________
Did you take Qualifying Examination? YES /NO Result: PASS / FAIL
Year of appearing in Ph.D. Qualifying Examination: ______________
10. Permanent Address: _____________________________
_____________________________
_____________________________
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Application No. PH ____________
PART II
PH.D. ASPIRANTS INFORMATION
(To be filled in by applicants for Ph.D. off-campus programme)
Tick ( ) appropriate boxes and strike off portions not applicable
I.GENERAL
1.1 Full Name in Block letters _________________________________________
(As given in your degree certificate)
1.2 Office Address for : _____________________________________Communication
______________________________________
________________ PIN___________________
Phone No.: _____________________ Fax No ____________________
Email: ______________________________________ Mobile No: _____________________
1.3 Nationality: _____________ 1.4 Sex: Male Female
1.5 Date of Birth _____________ 1.6 Age (in years): ________ 1.7 Marital status: Single/Married
II. EMPLOYMENT RECORD
2.1 If you are presently employed, give details:
Designation:_____________________________ Organisation _____________________________________
Place: __________________________________
2.2 Employment record
Employer Period No. of years Designation and nature of responsibilities
From To
Total experience in completed no. of years: ___________yrs. (Mention experience beyond the qualifying degree)
III.ACADEMIC RECORD
3. 1 List your qualifications (beyond H.Sc. /10+2)
Degree Year of
Passing
Duration Division/
percentage
College/Univ .
.
On a full/
part time basis
Subjects
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3.2 List your degrees/diplomas/memberships awarded by professional societies or correspondence colleges.
Society/ College Degree/Diploma Year Through exam/Professional experience
3.3 Are you holding a higher degree (M.E./M.Phil./M.Pharm. /M.S. etc.) of BITS or its equivalent ?
(Do not tick ( ) Yes if holding only M.A/M.Sc./MBA./L.L.B/M.B.B.S./B.Pharm.) Yes No
If yes, give
Higher degree name and discipline _________________________________________________
University _________________________________________ Year of Passing ______________
Duration _________________yrs. No. of courses in the degree _______________________
Completed as a: Full time student Part time student
If No, are your professional attainments equal to the courses of a higher degree of BITS? Yes No
(Consult Guidelines to Ph.D. Aspirants)
3.4 Outline on a separate sheet of paper claims of your high professional standing and research competence (List and
attach documents like research papers, published books, technical reports on innovative product/ process development,
etc.)
3.5 What is your motivation for Ph.D. programme (Enter 'Y' against all those applicable).
(a) To help further career at job (b) For personal enrichment
(c) For the benefit of employer/Organisation (d) An avenue for future employment
(e) Any other, specify _______________________________
IV. ANTICIPATED PLAN FOR Ph.D.
4.1 Place of work (Attach a brief profile of your organization)
City ________________________ Organisation _____________________________________________
4.2 Topic of research ___________________________________________________________________
__________________________________________________________________________________
4.3 Name of proposed supervisor: _________________________________________________________
Designation and Organisation: ____________________________________________________________
Qualifications: _________________________________________________________________________
Nature of his affiliation with your Organisation: _______________________________________________________
4.4 Any foreign language other than English required to pursue research in the above topic:
____________________________________________________________________________________________
Note: Please note that there has to be a co-supervisor from the faculty members of any of the BITS, Pilani
campuses.
(Enclose one typed copy of the details of your research proposal as per the format mentioned in the
guidelines , organizational profile in the prescribed format and also enclose copy of supervisor's bio-dataand his consent to act as supervisor.)
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V. DETAILS FOR Ph.D. QUALIFYING EXAMINATION
5.1 Did you ever get permission to appear in the Qualifying examination? Yes No
If yes, dates of appearing: 1st attempt (month and year) _____________
2nd attempt (month and year) _____________
Result: Pass Fail
5.2 Details of Higher Degree (M.E./ M.Phil./M.S./M.Pharm., etc.) courses. Attach marksheet, syllabus, and question
papers of final examination, if degree is not of BITS.
Degree Name: ____________________________
S.No. Course Name Prescribed Text Book
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
VI. ANY OTHER INFORMATION YOU WISH TO GIVE
VII. DECLARATION BY THE APPLICANT
I have carefully read the instructions and I hereby declare that all the information given and statements made in this
application and also in other parts of this form and enclosures are true to the best of my knowledge. I agree to the
condition that if any information or statement is found to be wrong, my admission to BITS would automatically becancelled.
If admitted, I promise to abide by the rules and regulations in force or those that may hereafter be made by the
administration of the Institution and I shall do nothing, which will interfere with its orderly working and discipline. In all
matters concerning me and all branches of the Institute, the decision of the Vice-Chancellor shall be binding on me.
Place ____________ Signature _________________________
Date _____________ Name ____________________________________
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VIII. EMPLOYER'S RECOMMENDATIONS (To be filled by employer)
8.1 Does you organization have any collaboration with any of the campuses of BITS Pilani? Yes No
If Yes then give details about nature of collaboration:
PSI PSII Work Integrated Learning Program Sponsored research collaboration
Other Give Details_________________________________
If your organization currently does not have any collaboration with BITS Pilani, then please provide a letter of intent
from Head of your organization indicating interest and nature of collaboration.
8.2 Tick () below the nature of sponsorship being recommended by you:
The Organization is the employer of the student and pays the full fees of the student and also provides the
educational facilities for research work.
The Organization is an employer of the student but pays only the part fees amounting to Rs. ________ and
provide educational facilities for research work.
The Organization is the employer of the student but does not pay the fees of the student. Nonetheless, the
Organization agrees to encourage the special nature of the educational process for the mutual benefit of the
Organization and the employee, and provides educational facilities for research work.
8.3 BITS, under the Ph.D. Aspirants scheme, is catering to sponsored candidates of high professional standing and proven
professional competence. It is necessary to examine and match the candidate's aspirations with the organizational goals
and facilities that the Organization is able to offer. Please answer the following in the above context:
(a) Would the Organization be able to suggest a supervisor from amongst the senior professionals/consultant in theOrganization for the conduct of the Ph.D. progamme of the candidate? If yes, give name, designation andqualification of the proposed supervisor.
Name ___________________________________ Qualification ___________________________________
Designation _______________________________ Organization ___________________________________
If the proposed supervisor is not an employee of the Organization, state below how is he associated with theOrganization?
(b) List below major equipments available with the Organization for research work e.g. computers, analyticalinstruments, etc.
(c) State how is the proposed research work suited to the organizational goals:
8.4 Declaration by employer (from an authorized individual of the Organization).
This is to certify, that to the best of our understanding, the information provided by Mr./Ms. __________________ anemployee of this Organization is true. The Organization supports his candidature for Ph.D. degree and will provide the
necessary educational facilities for research work.
Date ________________ Signature ____________________________
Place _____________________ Name ___________________________________
Designation ___________________________________
Name of Organization ____________________________________
Seal ______________________
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Application No. PH ______________
PART II ABSTRACT
Ph.D. ASPIRANTS INFORMATION
Name: _______________________________________________________
Topic of Research ______________________________________________
Designation: __________________________________________________
Organization: ____________________________ City: ________________________
Nationality: ______________________________________________________________
Place of work & Organization. _______________________________________________
Sex: _________ Age: _____________________
Supervisor's Details:
Date of birth: ____________________________ Name: _____________________________________
Qualifications: ______________________________________________
Highest Degree: ______________________ Designation: ____________________________________
Discipline: ______________________ Organization: ______________________________________________
University: ______________________________ Year of passing: ___________________
Experience: ____________ No. of Year(s):
Address: ____________________________________________________________________________
_____________________________________________________PIN CODE ______________________
STD Code: ______________ Telephone: _________________ Fax:________________
Email:____________________
-------------------------------------------------------------------------------------------------------------------------------------------
Check-List of Enclosures by Ph.D. Aspirants. Tick () the boxes.
1. Certificate and Mark sheet of Higher degree (HD) courses (M.E./ M. Pharm./ M.S./M.Phil.)
2. List of Textbooks of all HD courses
3. Syllabus of all HD courses
4. Question papers of final examination of HD courses
5. Professional documents for Higher Degree courses (M.Phil. (Applied) Route)
6. Outline of Proposed Topic of Research
7. Supervisor's consent and his biodata
8. Consent of Supervisor's Organization permitting him to act as supervisor
9. Summary and documents describing high professional standing and competence (item 3.4)
10. Profile of your organization
11. Letter of intent of collaboration if not having collaboration at present
12. Any other, specify ___________________________
Note: Please make sure that all the relevant enclosures are attached with the application form. Incomplete
applications will be rejected.
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BITS, Pilani
Application No: PH ________________
Detach and Retain
INSTRUCTIONS TO APPLICANTS
1. Read the Instructions and our advertisement carefully before filling the Application form.
2. The number of your application form is unique. In all subsequent correspondence with the Institute make sure that invariably
you quote this application number.
3. An appropriate declaration by the employer is required for employed and sponsored candidates.
4. Generally all candidates for admission to Ph.D. have to appear for interview/interaction at Pilani at their own expense.
5. If you are a candidate for admission to off-campus Ph.D. programme under Ph.D. Aspirants' scheme, you should fill both Part
I and Part II of the application form along with the respective Abstract pages. You should send the application form through
your organization duly completed by the deadline. Before filling carefully read the Guidelines for submitting application under
'Ph.D. Aspirants' scheme. Only professionals of high standing and proven competence may apply through this route, which
provides for permission to appear in the Ph.D. Qualifying examination even before admission formalities are completed. On
successful completion of the qualifying examination, the candidate has to immediately seek admission. Schedule of fee inforce at the time of admission shall be applicable to such candidates.
6. For Ph.D aspirant candidates, one faculty member from any of the campuses of BITS, Pilani should act as either co-supervisor
or supervisor
7. This scheme is meant for candidates from organizations which are having some collaboration with BITS, Pilani. If candidates
organization is currently not having any collaboration then it is essential to establish collaboration with BITS Pilani before theapplication can be considered.
GUIDELINES FOR SUBMITTING
APPLICATION FOR Ph.D. OFF-CAMPUS PROGRAMME UNDER Ph.D. ASPIRANTS' SCHEME
A . Information and Documents to be submitted for Ph.D Qualifying Examination
1. Candidates holding a Higher degree of BITS or its equivalent (M.E./M.Pharm/M.Phil./M.S./MBA) and opting to take qualifyingExamination on selected two areas based on the course package of this Higher degree:
(Each candidate has to indicate two areas for qualifying examination from amongst the areas of research of the respective
department. Please visit the respective department website for more details on areas of research.)
(a) Marksheet & List of courses and syllabus of each course prescribed for the fulfillment of the higher degree.
(b) List of Prescribed textbooks for each course.
(c) Final examination question papers for each course.
(d) Two areas chosen for the qualifying examination from amongst the areas of research of the respective department
Higher degree by Thesis or Research alone is not adequate for the Qualifying examination.
2. Professionals of high standing and proven competence, whether holding a first degree or not but opting to take QualifyingExamination based on professional experience:
Should identify the Higher Degree of BITS and its prescribed course package in which Ph.D. qualifying examination is to betaken and to which the professional standing can be notionally equated. As per past experience it its observed that the
M.Phil. (Applied) degree of BITS is most suited for many candidates in this category. A list of courses for this degree is givenbelow, from which a minimum number of eight courses are to be chosen.
BITS E511 Computer Application I
BITS E512 Computer Application II
BITS E521 Technical Communication I
BITS E522 Technical Communication IIBITS E531 Social, Behavioral & Economic Science I
BITS E532 Social, Behavioral & Economic Science IIBITS E533 Modern Experimental Techniques I
BITS E534 Modern Experimental Techniques IIBITS E535 Management Methods & Techniques I
BITS E536 Management Methods & Techniques II
BITS E537 System Sciences and Engineering I
BITS E538 System Sciences and Engineering II
BITS E541 Chemical and Life Science I
BITS E542 Chemical and Life Science IIBITS E543 Instrumentation Engineering I
BITS E544 Instrumentation Engineering IIBITS E545 Project & Consultancy I
BITS E546 Project & Consultancy II
BITS E547 Public Administration I
BITS E548 Public Administration II
BITS E551 Physical and Mathematical Sciences I
BITS E552 Physical and Mathematical Sciences IIBITS E561 Use of English for Professional Purposes I
BITS E562 Use of English for Professional Purposes IIBITS E571 Methods & Planning & Development I
BITS E572 Methods & Planning & Development IIBITS E573 Study in Advanced Topics I
BITS E574 Study in Advanced topics II
BITS E583 Case Studies I
BITS E584 Case Studies II
BITS E591 Science & Technology Development I
BITS E592 Science & Technology Development IIBITS E593 Reading Courses I
BITS E594 Reading Courses IISKILL G661 Research Methodology I
SKILL G662 Research Methodology II
See the BITS website for the course descriptions for above courses to arrive at the correct course package according to
one's professional experience.
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For each of the course identified in the above package, technical documents, published papers and reports prepared by the
candidate in his professional capacity have to be compiled and submitted. The coursewise documents are examined and a
pronouncement of suitability for the purpose of Ph.D. Qualifying examination is made. These documents will broadly form
the syllabus besides some prescribed readings.
Based on the documents if the candidate is considered eligible for qualifying examination, two areas will be recommended
for qualifying examination.
3. Ph.D. Qualifying examination consists of three written papers, each of 2-4 hours duration and an oral test. The writtenpapers are based on the suggested two areas based on the courses of the higher degree of BITS or an equivalent degree
from another University of repute and are generally open book. The Qualifying examination will test the candidate'sknowledge, grasp of fundamentals and his ability to use them in unknown situations.
B. Additional Information to be provided for deciding overall suitability
1. The proposed place of work and certificate stating availability of facilities for research work by the Organisation.
2. Tentative details of proposed topic of research and supervisor in the format given below:
i) Name of the candidate
ii) Organisaiton and Place of work
iii) Name of the Proposed Supervisor, his qualification, designation & Organisational affiliations.
iv) Proposed topic of research
v) Background of proposed research
vi) Methodology/Work Plan
vii) Literature references
viii) List of Instruments & equipments needed for research work
ix) Are these facilities for research work ensured by the Organisation? (Attach certificate.)
x) Other details, if -any
3. i) Proposed supervisor's consent and his biodata
ii) Consent of supervisor's Organisation permitting him to act as supervisor
iii) Nature of his association with the candidate's Organisation, if working in a different Organisation
C. Interview
Potential candidates may be called for a face-to-face interaction at Pilani, for which they will be duly informed. They
should attend this interaction on the specified dates. No correspondence will be entertained for change of dates of
interaction.
No TA/DA is paid for attending the interaction. Accommodation in the Institute visiting faculty and student's hostel
may be provided on payment basis.
D. General Information
(a) The Ph.D. Aspirants Scheme is aimed to provide avenues for doctoral research to professionals of high standing and
proven competence drawn from Industries, R&D organizations, Government departments etc. having collaboration
with BITS Pialni, without being disturbed from their work places. This scheme is not the traditional external
registration scheme.
(b) Candidates holding only integrated first degree of BITS or equivalent do not normally qualify for admission to Ph.D.
under Aspirants scheme unless such candidates have at least 10-15 years of professional experience and are able tosubmit technical reports and published papers prepared by them in their professional capacity.
(c) Candidates holding a first degree and with inadequate experience are advised to apply for admission to M.S.
degree programmes of the Institute offered through distance learning.
(d) Ensure that all items given in the checklist of enclosures in Part II are submitted along with the application.
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