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AMRITA SCHOOL OF BUSINESS
Amrita Nagar, Ettimadai, Coimbatore – 641 112, Tamilnadu, India.
APPLICATION FORM FOR ADMISSION TO Ph.D. PROGRAMME (Part Time)
(All columns to be filled only in CAPITAL LETTERS – enclose attested copies of certificates)
1. Name of the candidate as given in the SSLC or equivalent certificate (leave blank space between name and initials)
Gender Religion Community / Caste
Male Female OC BC OBC MBC SC ST
2. Father’s Name: _______________________________________________________________________
3. Mother’s Name: ______________________________________________________________________
4. Communication Address Permanent Address
Pin Pin
Phone: STD code - Phone: STD code -
Mobile: Email:
5. (a) Functional Area to which the applicant seeks admission (Marketing, Finance, HR, Operations, Economics etc.):
(b) Statement of Purpose and a Brief Research Proposal: __________________________________________
(Please enclose the Statement of Purpose and a Brief Research Proposal separately. The statement of purpose should
clearly explain why you want to do a PhD in the area of Management. Brief research proposal should explain your
proposed broad research topic and research questions if any)
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6. Academic Record:
Average % of marks.
S Degree
College University Year CGPA (on a 10 point
No. Obtained
scale)
1.
2.
3.
Note: If any degree (UG or PG) was obtained through correspondence course / distance education mode, please specify.
7. Additional examinations passed if any (like ICAI/ICWAI/Company Secretaryship/UGC- JRF/ Lectureship/ CSIR/DAE etc.
8. Professional experience (Teaching/ Research/ Industrial), if any:
S Period
Organization Designation & Nature of work
No. From To
1.
2.
3.
9. Please enclose 3 letters of reference from persons you know professionally. List the Name, Designation and Affiliation
of your referees.
Name Designation Affiliation
10. Personal Details.
Blood Group: ________________________ Native Place: _____________________________
Date of Birth: ________________________ Native District: _____________________________
Marital Status: ________________________ Nationality: _____________________________
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11. How did you come to know about Amrita School of Business?
12. Why are you choosing Amrita School of Business for your doctoral research?
13. List of documents to be enclosed. (Please send only the attested copies)
1. SSLC or Equivalent Certificate.
2. Plus two Certificate.
3. Degree/ Provisional Certificate.
4. Statement of marks for all the Semester/ Years.
5. Certificate/Mark sheet of additional examinations in respect of serial no. 8.
6. Transfer Certificate and Conduct Certificate from the Institution last attended.
7. Certificate of Physical Fitness from a Registered Medical Practitioner not below the rank of Asst. Civil Surgeon.
8. The Statement of Purpose
DECLARATION
I, _________________________________________ Son/ Daughter of ____________________________________ hereby
declare that the particulars given by me in the application are true. I shall produce the original certificates at the time of
admission or on demand. If, in future, any information is found to have been furnished falsely or incorrectly or any
information suppressed to secure admission, I shall withdraw from the programme without any claim or consideration. I
further state that I have read and understood the contents of the instructions and the brochure given with the application
before filling the application.
Place: Signature of the Applicant:
Date: Name:
The completed application together with the necessary enclosures should be submitted to:
The Chairperson – Ph.D.
Amrita School of Business
Amrita Vishwa Vidyapeetham
Amritanagar, Ettimadai,
Coimbatore – 641 112.
Phone: 0422 - 2685403
along with a demand draft of Rs. 1000/- in favour of “Amrita Vishwa Vidyapeetham – Amrita School of Business”
payable at Coimbatore.
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