PROJECT GUIDE REGISTRATION FORM

ANNEXURE I

PROJECT GUIDE REGISTRATION FORM

(To be submitted to the Project Steering Committee)

Instruction: Please provide the below details about your Proposed Project Guide:

1. Name of the Proposed Project Guide:

2. Date of Birth:

3. Present Employer: Affix Your Latest Photo

4. Designation:

5. Contact Details:

i) Residential Address:

ii) Office Address:

iii) All communications are to be sent to Residential/ Official address (tick anyone)

iv) Contact No.:

v) E-mail id:

6. Education Qualification (start with the highest qualification):

(Please attach photocopies of degree certificates)

S. No. Name of the Degree Specialization Year of Passing Institution/University Class Obtained

7. Area of Specialization/Interest:

8. Total yrs. of Experience: (Please attach photocopies of Experience letters)

S. No. Name of the organization Designation From To

I hereby declare that the information provided by me is true. I agree with the rules and regulations given by the University.

Signature (Proposed Guide)

(FOR OFFICE USE)

Following details have been verified

Sl. No Yes No

1 Qualification 2 Experience 3 PAN Card (in case of Domestic Guide) 4 Passport (in case of Foreign Guide) 5 Approved for Department / Specialization Signature Signature

(Faculty in-charge) (Project Steering Committee)

(Note: Filled in Registration forms must be scanned in either .pdf / .doc format and submitted along with credentials (Scanned copy of Degree Certificates, PAN Card (for Domestic Guide), Passport (for Foreign Guide) and Experience Certificates of the proposed guide) on LMS portal- link).