Application for admission of college/university student(s)
for dissertation/project work at CSIR-CECRI, Karaikudi-630 003
2018-2019
Name of student (Capital letters) :
Date of birth :
Name of college and :
address with pin code,
phone, fax No. & e-mail
Category (copy of the certificate
should be enclosed to avail
relaxation in marks ) : General /OBC/BC/MBC/DNC/SC/ST/
Course with subject name &year of study:
Details of marks secured in MSc/ME/MTech (semester-wise)
Degree College / From - To Subject % of Marks /Grade
MSc/ 1st semester
ME/ MTech 2nd semester
MPhil 1st semester
Details on dissertation work to be carried out:
(i) Duration: 3 /6 /12 Months: From To
(ii) Area or division in which wish to work (please see CECRI website for details):
1.
2.
3.
(iii) Have any preliminary negotiation been made earlier? : Yes / No
If yes, please furnish the particulars along with one page write up:
Counter Signature Student’s Signature
of HOD/ Principal