Application No.

Ph.D.
(Not for online)
Paste your
INDIAN INSTITUTE OF TECHNOLOGY DELHI recent
Application Form for Admission to Ph.D. Programme unattested
Please read the instructions given in the information Brochure BEFORE you fill up the form photograph
(Visit: http://www.iitd.ac.in/pgadmission for details)
Tick (√) the relevant box wherever provided
Full time with Assistantship Employed Candidates (No assistantship)
Source of Assistantship Sponsored (Full time) Part-time
INSTITUTE CSIR
M.Tech. Degree
OR
CATEGORY

GATE Description Year GATE Score GATE Marks (%)

UGC NET Experience Experience
…………………………….. ………. ………… …………….
Years……………. Years…………….
UGC JRF

Tick GENERAL OBC SC ST PH

whichever
is applicable
(Non-Creamy Layer)
Department/Centre Ph.D. Code
(Write here name of only One Department/ Centre (See Annexure-I of Information Brochure)
CHOICE

You are applying to)……………………………………………………………………………………………

Proposed Area of Research

Name (in CAPITAL)

Gender/D.O.B. Male Female Other Date-of-birth (dd/mm/yyyy)

Father’s Name
Mother’s Name
PERSONAL

Address for
Correspondence
PIN : Tel No. with STD Code
Email: Mobile No:
Permanent
Address
PIN: Tel No. with STD Code
Email: Mobile No:

Qualifying Exam…………………………………… Duration of the course (Years)…………………………….. …………………Discipline………………………………………………

QUALIFYING DEGREE

Year of Passing……………………………………… Name of University/ Institute…………………………………………………………………………………………………………………

Marks Obtained Max. Marks Marks Obtained Max. Marks

CGPA/ Year 1 Semester I ……………………… ………………. Semester II …………………….. ………………………

Marks
Obtained Year 2 Semester I ……………………… ………………. Semester II ……………………… ………………………

Year 3 Semester I ……………………… …………….... Semester II ……………………… ………………………

Year 4 Semester I ……………………… ………………. Semester II ……………………… ……………………..

CGPA Secured out of OR Aggregate % of marks (of all years/semesters)

Details of Marks Secured in the Examinations other than qualifying examinations

Exam./ Degree Discipline Institute/ University Year of Passing % Marks/ CGPA Rank in Class/ University
PREV. ACAD. REC.

10+2/ Equivalent
B.Sc./ BA
M.Sc./B.Tech
MA
Other (specify)
 Experience (From date to date) Designation Organization with address

EXPERINCE IF ANY

List of Publications (Attach Separate Sheet if required)

Application fee: Amount: Rs. ________ Date: ___________ Amount - GEN/OBC Rs. 300/-
SC/ST/PH Rs. 150/-
PAYMENT

The Payment of the applicable fee is to be made online through the link:
http://www.iitd.ac.in/icollect/epay/index.html#misc by choosing IITD Misc Payment. A printout of proof of
payment is to be enclosed.

Have you ever studied and discontinued your studies at IIT Delhi? YES NO

If YES, give Entry number and the particulars of the

programme earlier attended and the reason for discontinuation.

Date_______________ (Signature of the Candidate)

FOR DEPARTMENT/CENTER’S/SCHOOL'S USE

FOR P.G. SECTION USE ONLY

(Recommendations/observations of the office)

The candidate may be provisionally admitted/not admitted subject to the following:

1) Submission of attested copies of the qualifying degree certificate and marks sheet showing the required
% of marks/CGPA.
2) Submission of proof from the University / Head of the institution of having appeared/passed in the
qualifying Degree Examination.
3) Submission of GATE Score Card/CSIR/NET award letter (in original).
4) Submission of relieving certificate from Employer by………………………….
5) Submission of an attested copy of OBC/SC/ST certificate.
6) ………………………………………………………………………………………………………………………………………………………………

JR (Academics) Signature of OS (PGS&R)