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IITGnPhDApplication Form

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INDIAN INSTITUTE OF TECHNOLOGY GANDHINAGAR

Application Form for Admission to Doctoral Programme

Ph.D. Program in:


(Fill disciplines of your choice in order of preference. Only one form need be submitted by a candidate) Paste passport
size photograph
1. 2. 3.

Disciplines: Chemical Engineering, Civil Engineering, Electrical Engineering,


Mechanical Engineering, Computer Science, Cognitive Science,
English, Philosophy, Chemistry, Mathematics
Name (as in qualifying degree certificate)
First Name
Middle Name
Paste passport
Last Name
size photograph

Contact details
Address for communication: Permanent Address:

Pin Pin
City: City:
Code Code
State: State:
Telephone Number Mobile Number Email Address:
Alternate Email Address:

Date of Birth Nationality Sex (M/F) Category: GN/OBC/SC/ST

Category under which you want to apply (Please check appropriate box)
Regular (RR): Fulltime residential External (ET): Candidates serving in
researcher candidate educational/research institution/Industry*
*All ET applications must include employer’s support/sponsorship letter
GATE score/UGC-NET/CSIR-UGC
Name of Examination Year Score/Percentile Validity Period All India Rank
(if applicable) (AIR)

Details of academic record (From 12th Standard Onwards) ) [IMPORTANT: Please attach the attested copies of necessary documents]

Degree Subject College University/ Year of Class/ % of Marks/Grade


Institute Passing Division /CGPA

Details of Any Research/Professional Experience or Publication


Details Any Past Employment
Duration
Organization Designation
From To

Declaration: I hereby declare that the information given above is correct to the best of my knowledge and belief. I am
also aware that providing incorrect information in the application form can result in the cancellation of my admission at
any stage.
Place:
Date: Signature of the Applicant

Please send the completed application form to the following address with “PhD Application” written on the envelop

Assistant Registrar (Academics)


Indian Institute of Technology Gandhinagar
VGEC Campus, Chandkheda,
Ahmedabad – 382424
Phone: 09328474222, Fax: 07923972324
E-mail: phd.application@iitgn.ac.in

Check List for Enclosures:


Copy of Marksheets / Grade cards (From 12th standard onwards)
Statement of purpose
Copy of GATE score/UGC-NET/CSIR-UGC
Copy of Certificate of SC/ST/OBC (if applicable)
Employer’s support/sponsorship letter (in case of External candidates)

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