Application No.

UNIVERSITY OF MYSORE
Research Centre, Pareeksha Bhavan, Mysuru – 570005, Karnataka, India

APPLICATION FOR LETTER OF PERMISSION TO SEEK RESEARCH VISA

(FOR FOREIGN STUDENTS)

01 Name

02 Qualification

03 Permanent Address (in the country of residence with Phone Number)

04 Contact Address in Mysuru with Phone Number

05 Place of work with Address

(if employed)
06 Institution where doctoral
research will be carried out

07 Name of the Guide

08 Subject in which he/she wishes

to pursue research

09 Title of the research topic :

Signature of the Signature of the Signature of the Chairperson/

Applicant with date Research Guide Director / Co-ordinator /
(with seal) Principal (with seal)

Enclosures
The following documents are to be attached with this application :
A. Marks Cards of Masters Degree Examination (All semesters)
B. Letter of Acceptance from the Guide (Original)
C. Copy of Latest Passport
D. Research Proposal
E. Certificate of Eligibility (those with degrees awarded by University of Mysore are exempted
from producing this certificate)

i
Application No. :
Affix
UNIVERSITY OF MYSORE Stamp
Size
Photo
Research Centre, Pareeksha Bhavan, Mysuru – 570005, Karnataka, India

APPLICATION FOR PROVISIONAL REGISTRATION FOR Ph.D. in _______________

01 Name
02 Highest Education Qualification (Enclose Photo copies duly attested)
Post Graduate Degree & Year of Passing Percentage of
Specialization University
Subject / Appearing Marks Secured

03 Permanent Address of the Candidate 04 Name & Official Address of the Guide

04 Contact Number / Email ID

05 Category : GM/SC/ST/Cat-1/OBC/PH
06 Address of place of work, if employed
07 Department / Research Centre recognized by
University of Mysore, where Doctoral Research
will be carried out
08 Status : with /without fellowship / in service*
*(those employed must enclose the NOC)
09 Name and Official address of the
Co-guide(s), if any
10 Whether cleared UGC JRF/UGC-CSIR
JRF/GRE / GATE / NET / SLET / M.Phil through
Entrance (Enclose photo copy of the relevant
documents duly attested)
11 Details of fee paid : Name of the Bank and Branch

DD/ Challan No. ______________________ Date ________________ Amount _______________

I certify that the above information furnished is true to the best of my knowledge.

-------------------------- -------------------------- ---------------------------------

Signature of the Signature of the Counter Signature of
Candidate Guide & Co-guide (s), if any Chairperson / Director
(with date) (with seal & date) (with seal & date)

Enclosures : The following documents are to be attached along with the form for Provisional Registration.
1. Attested photocopies of Masters Degree Certificate and Marks Cards.
2. Attested photocopy of Fellowship award document (for candidates with fellowship).
3. No Objection Certificate from the Employer, in Original (for in-service candidates).
4. Acceptance Certificate from the Guide and Co-Guide(s), in original.
5. Guide’s declaration Certificate about number of candidates presently working under him/her. Similar
declaration from co-guide(s), if any.
6. Bank Challan (Original) for having remitted the provisional registration fee.
7. Migration Certificate for other University Students, NOC (from International Centre), Research Visa &
Residential Permission Letter (from Police Commissioner) for the Foreign National Candidates.

ii
Application No. :
ªÉÄʸÀÆgÀÄ «±Àé«zÁ央AiÀÄ Affix
Stamp Size
Photo
UNIVERSITY OF MYSORE attested by
the HOD

………………………………………………………. «µÀAiÀÄzÀ°è ¦ºÉZï.r ¥ÀzÀ«UÁV £ÉÆÃAzÀt Cfð

APPLICATION FOR REGISTRATION FOR Ph.D. DEGREE IN THE SUBJECT
……………………………………………………………………………
(2010 wzÀÄÝ¥Àr ¤AiÀĪÀiÁªÀ½UÀ¼À ¥ÀæPÁgÀ) [as per 2010 Regulations (Amendment)]
01 ¸ÀA¥ÀÇtð ºÉ¸ÀgÀÄ (zÀ¥ÀàPëg
À ÀU¼
À À°)è
Name in full (in block letters)
02 SÁAiÀÄA «¼Á¸À zÀÆgÀªÁt ¸ÀASÉå :
Permanent Address in full Telephone No. :

F-CAZÉ :
E-Mail :

03 °AUÀ : UÀAqÀÄ / ºÉtÄÚ gÁ¶ÖçÃAiÀÄvÉ

Sex : Male /Female Nationality
04 ¥ÀæªU
À Àð ¸ÁªÀiÁ£Àå / ¥À.eÁ. /¥À.¥ÀA / ¥ÀæªU
À Àð-1
Category General / SC / ST / Category 1
05 ¸ÁßvÀPÉÆÃvÀÛgÀ ¥ÀzÀ«UÀ¼À «ªÀgÀUÀ¼ÀÄ
Details of Post-graduate Degrees
±ÉÃæ tÂ/ ±ÉÃPÀqÀ
¥ÀzÀ« «±Àé«zÁ央AiÀÄzÀ ºÉ¸ÀgÄÀ ªÀµÀð CzsÀåAiÀÄ£À ªÀiÁrzÀ «µÀAiÀÄUÀ¼ÀÄ zÀeðÉ CAPÀUÀ¼ÄÀ
Degree Name of the University Year Subjects Studied Class / Percentage
Grade Marks
¸ÁßvÀPÉÆÃvÀÛgÀ
PG
JA.¦ü¯ï
M.Phil
06 GzÉÝòvÀ ¦ºÉZï.r. ªÀĺÁ¤§AzsÀzÀ ²Ã¶ðPÉ ªÀÄvÀÄÛ ¨sÁµÁ ªÀiÁzsÀåªÀÄ
(GzÉÝòvÀ PÁAiÀÄð AiÉÆÃd£ÉAiÀÄ£ÀÄß F CfðAiÉÆqÀ£É ®UÀwÛ¸¨
À ÉÃPÀÄ)
Title of the proposed Ph.D. thesis and language
(Proposed Synopsis must be enclosed with this
application)
07 GzÉÝòvÀ ¸ÀA±ÉÆÃzsÀ£Á PÁAiÀÄðªÀ£ÀÄß ¤ªÀð»¸À®Ä ªÀÄvÀÄÛ
ªÀĺÁ¥À§ æ AzsÀª£À ÀÄß ¹zÀÞ¥rÀ ¸À®Ä C¨sÀåyðAiÀÄÄ DAiÉÄÌ ªÀiÁrPÉÆArgÀĪÀ
¸ÀA¸ÉAÜ iÀÄ ºÉ¸ÀgÀÄ ªÀÄvÀÄÛ «¼Á¸À
Name and address of the Institution chosen to carry out
the proposed research work and prepare the Ph.D.
thesis
08 C¨sÀåyðAiÀÄÄ ¦ºÉZï.r ¥ÀzÀ«UÉ ºÉ¸g
À ÀÄ zÁR°¹zÁÝgÉAiÉÄÃ? ºÉ¸g
À ÀÄ ºËzÀÄ / E®è
zÁR°¹zÀg Ý É, MAzÀÄ ¥ÀæwAiÉÆqÀ£É, DzÉñÀzÀ G¯ÉÃè R ªÀÄvÀÄÛ
Yes / No
¢£ÁAPÀªÀ£ÀÄß ¤Ãr Has the Candidate enrolled for Ph.D.
Degree? If Yes, provide order reference with date and a
copy of the order
09 ªÀiÁUÀðzÀ±ðÀ PÀgÀ «ªÀgÀU¼
À ÀÄ Details of the Supervisor
ªÀiÁUÀðzÀ±ÀðPÀgÀ ¸ÀA¥ÀÇtð ºÉ¸ÀgÀÄ Supervisor Name in full

iii
 ¥ÀÇtð «¼Á¸À Address in full zÀÆgÀªÁt ¸ÀASÉå :
Telephone No. :

F-CAZÉ :
E-Mail :

10 ¸ÀA±ÉÆÃzsÀ£Á C¨sÀåyðAiÀÄ ¸ÁÜ£ÀªÀiÁ£À

Status of the research Candidate Full Time / Part Time
11 C¨sÀåyðAiÀÄ ¸ÀA±ÉÆÃzsÀ£Á «zÁåyðªÉÃvÀ£À ¥ÀqAÉ iÀÄÄwÛgÀĪÀgÉ? ºËzÀÄ / E®è
Is the candidate getting research fellowship? Yes / No
ºËzÉAzÀg,É ¸ÀA±ÉÆÃzsÀ£Á «zÁåyð ªÉÃvÀ£À ¤ÃqÀÄwÛgÀĪÀ ¸ÀA¸ÉÜAiÀÄ ºÉ¸g
À ÀÄ
If Yes, Name of the Institution granting the research fellowship

¸ÀA±ÉÆÃzsÀ£Á «zÁåyðªÉÃvÀ£À UÀ½¹zÀ ¢£ÁAPÀ

Date of selection granting the research fellowship
¸ÀA±ÉÆÃzsÀ£Á «zÁåyðªÉÃvÀ£ÀzÀ CªÀ¢ü
Duration of the research fellowship
J¥sï.L.¦ / EvÀgÉ (zÀAiÀÄ«lÄÖ £ÀªÀÄÆ¢¹)
F.I.P / Others (please specify)
12 C¨sÀåyðAiÀÄÄ GzÉÆåÃUÀzÀ°è EgÀĪÀgÉÃ? ºËzÀÄ / E®è
(GzÉÆåÃUÀzÀ°èzÀÝg,É GzÉÆåÃUÀzÁvÀjAzÀ ¤gÁPÉëÃ¥ÀuÁ ¥ÀvÀæ ¸À°¸ è À¨ÉÃPÀÄ.
Yes / No
E®è¢zÀÝg,É GzÉÆåÃUÀzÀ°è E®è JAzÀÄ ¸ÀéAiÀÄA-WÉÆõÀuÁ ¥ÀvÀæ ¸À°è¸À¨ÉÃPÀÄ)
Is the candidate Employed?
(If Yes, No-objection Certificate from the employer must be
furnished. If not employed, a self declaration must be
furnished stating „Not employed‟)
13 Cfð ªÀÄvÀÄÛ £ÉÆÃAzÀt ±ÀÄ®Ì ¥ÁªÀw¹zÀ «ªÀgU
À À¼ÀÄ
Details of payment of Application and Registration fees
ZÀ®£ï / gÀ²Ãw ¸ÀASÉå ªÀÄvÀÄÛ ¢£ÁAPÀ (ZÀ®£ï / gÀ²ÃwAiÀÄ ªÀÄÆ® ¥Àæw
®UÀwÛ¹) Challan / Receipt number and date (Please enclose
original Challan / receipt)
14 WÉÆõÀuÉ : F CfðAiÀÄ°è ¤ÃrgÀĪÀ J®è ºÉýPÉUÀ¼ÀÄ ªÀÄvÀÄÛ «ªÀgÀuU É À¼ÀÄ £À£Àß £ÀA©PÉUÉ w¼ÀĪÀ½PÉUÉ ¤d, ¸ÀA¥ÀÇtð
ªÀÄvÀÄÛ ¸ÀjAiÀiÁVªÉ JAzÀÄ F ªÀÄÆ®PÀ WÉÆö¸ÀÄvÉÛãÉ. AiÀiÁªÀÅzÉà ¸ÀAzÀ¨Àðs zÀ°è £Á£ÀÄ E°è ¤ÃrgÀĪÀ AiÀiÁªÀÅzÉÃ
ªÀiÁ»wAiÀÄÄ ¸ÀļÀÄî CxÀªÁ vÀ¥ÀÄà JAzÀÄ PÀAqÀħAzÀ ¥ÀPz
Àë À°è ¦ºÉZï.r ¥ÀzÀ«UÁV £À£Àß GªÉÄÃzÀĪÁjPÉAiÀÄÄ gÀzÁÝUÀĪÀ
¸ÁzsÀåvɬÄzÉ JA§ÄzÀ£ÀÄß £Á£ÀÄ CjvÀÄPÉÆArzÉÝãÉ.
Declaration: I hereby declare that all statements and details given in this application are true,
complete and correct to the best of my knowledge and belief. I understand that in the event of any
information being found false or incorrect, my candidature for Ph.D. degree is liable to be cancelled.

¸ÀܼÀ :
Place :
¢£ÁAPÀ : C¨sÀåyðAiÀÄ ¸À»
Date : Signature of the Candidate

¸ÀA±ÉÆÃzsÀ£Á ªÀiÁUÀðzÀ±ÀðPÀgÀ µÀgÁ, ¸À» ªÀÄvÀÄÛ ªÉƺÀj£ÉÆqÀ£É ¸ÀA¸ÉÜAiÀÄ ªÀÄÄRå¸ÀÜgÀ ¸À», ªÉƺÀj£ÉÆqÀ£É
Remarks of the Supervisor with signature and seal Signature with seal of Head of Institution

iv
Application No. :

ªÉÄʸÀÆgÀÄ «±Àé«zÁ央AiÀÄ
UNIVERSITY OF MYSORE

APPLICATION FOR Ph.D. DEGREE – (to be sent along with the thesis)

SUBJECT : ________________________________________________________________________

01 Name and Address in Full

02 Age, Nationality and Caste

03 Qualifying Exam and Year of Passing the same

04 Correlated subject in the qualifying examination

05 The date of registration to work the Ph.D. Degree

06 Title of the Thesis :

07 Details of fee paid : Name of the Bank and Branch

DD/ Challan No. ______________________ Date ________________ Amount _______________

08 Name of the institution in which the candidate is

working

09 Whether the certificate from the Professor under

whom the candidate was taking guidance is
attached
10 Whether the Thesis or Part of it was the basis
for the award of a Degree or Fellowship
previously

11 Date of submission of the Thesis

I declare that the Thesis I am presenting entitled ………………………………………………………..

…...…………………………………………………………………… is prepared by me under the guidance of
………………………………………………………………………………………………………………………...…
and has not formed the basis of the award of any Degree or Fellowship previously.

Signature of the Signature of Signature of the

Applicant the Guide Head of the Institution

v
 ªÉÄʸÀÆgÀÄ «±Àé«zÁ央AiÀÄ
UNIVERSITY OF MYSORE

ENCLOSE THE FOLLOWING DOCUMENTS WITH THE SUBMISSION OF THESIS

01 Duly filled in application form for the Thesis submission

02 Plagiarism certificate by the library
03 Candidate Certificate Should be certified by the guide and Chairman
04 Attendance Certificate by the Guide
05 Research Guide Certificate for the Thesis and Research Publications
06 Verification Certificate by the Doctoral Committee about the Research Publications
(Certificate should be enclosed)
07 Ph.D. Permanent Registration Copy
08 Guide Recognition Certificate
09 Ph.D. Course-work Passed Certificate
10 Date of Pre-Registration Colloquium
11 Pre-submission Colloquium Report (signed by Doctoral Committee Members)
12 Photo copies of 10th & Master Degree Marks Cards & Convocation Certificate
13 Date of Ph.D. Registration Extension Letter
14 FOUR copies of Ph.D. Thesis
15 TEN copies of Final Synopsis
16 Submission fees paid ORIGINAL Challan (SC/ST & Cat – 1, 50%)
17 Soft copy of TWO CD Certified & Verified by Guide & Chairman
18 Two Copies of the Publication (Journals Xerox) Certified by the Guide & Chairman
19 NOC from Library, Department & Hostel
20 Emblem should not appear in the thesis
21 Service fees paid by per Candidate, ORIGINAL Challan (Registered through affiliated and
other Research Institutes)
22 Laboratory Fee Challan‟s – Xerox copies
For Foreign National Students (along with above said documents)
23 Visa & Passport
24 Residential Permit (As per Police Report {RP & RC})
25 NOC from International Centre
26 All Progress Report Challan‟s – Xerox copies
27 Special Fees for year :
a. Foreign National Candidates (Fee Challan Xerox)
b. Candidates from outside Karnataka [Considered as per SSLC & PG Marks Card (Fee
challan Xerox)]

vi
 ªÉÄʸÀÆgÀÄ «±Àé«zÁ央AiÀÄ
UNIVERSITY OF MYSORE
FINAL THESIS SUBMISSION CHECK-LIST (duly filled by candidate)
01 Name of the candidate (in block letters)
02 Name of the Guide (in block letters)
03 Name of the Research Institute
04 Permanent Registration Date
05 Course Work Certificate & Result Date
06 Pre-registration Colloquium Date
07 Pre-thesis submission colloquium date
08 Attendance Certificate from the Guide
09 Research Guide Certificate
10 Verification Certificate by the Guide and
Chairman about the research scholar’s
Publications
11 Candidate Certificate should be certified by
Chairman & Guide
12 Photo Copy of Guide Recognition Certificate
13 Plagiarism Certificate from the University Library
14 Passport Residential
Residential NOC date from
Foreign Country from & Visa from & Certificate from
Permit Valid International
Nationals Name Valid Valid date Police
date Centre
Date Commissioner

15 NOC’s from Library Department Hostel If any others

16 Progress reports, I Year II Year III Year IV Year V Year Extension Date
Annual fees paid
amount details
(Special Fees for FN & VI Year VII Year
Outside of Karnataka)

17 Laboratory Fees paid I Year II Year III Year IV Year V Year VI Year VII Year
date details

18 Processing Fees I Year II Year III Year IV Year V Year VI Year VII Year
amount paid details
(for other institutes &
guides)
19 Service Fees amount paid details (one time for
other Institutes)
20 2 Soft Copies 2 Copies of Date of Certificate from Library for
Thesis Submission Fees
of Thesis Publications Submission of Thesis Electronic version

Signature of the Candidate Signature of the Guide with seal

vii
 UNIVERSITY OF MYSORE
Research Centre, Pareeksha Bhavan, Mysuru – 570005, Karnataka, India

ANNUAL FEE SUBMISSION FORM

01 Name of the Candidate

02 Subject

03 Registration Number & Date

04 Annual Fee for the year (Please First Second Third Fourth
tick the appropriate year)
Fifth Extension Sixth Seventh

05 Payment Details

Name of the Bank DD No. / Challan No. DD / Challan Date Amount

06 Address for Communication

07 Contact Number

08 Email ID

09 Name of the Guide and Address

Place :
Date : Signature of the Candidate

Signature of the Guide with seal Chairman/Department/Institution Head

viii
 UNIVERSITY OF MYSORE
Research Centre, Pareeksha Bhavan, Mysuru – 570005, Karnataka, India

CERTIFICATE OF GENUINENESS OF THE PUBLICATION

This is to certify that Ph.D. candidate Mr./Ms./Mrs. ………………………………………..…

Reg. No. ……........................................ Subject: ………......................................... working

under my supervision has published a research article in the standard referred / SCI journal

named ……………………………………..……………………………… with Vol. No…………………

Page Nos ………………….…… and year of publication ………………originally published by

.……………………………………………….………………… the contents of the publication

incorporate part of the results presented in his / her thesis.

Date :
Place :

Signature of the Scholar Research Supervisor (with seal)

Chairman / Director

ix
 UNIVERSITY OF MYSORE
Research Centre, Pareeksha Bhavan, Mysuru – 570005, Karnataka, India

ANNUAL PROGRESS REPORT

Period of Report from: ……………………….. to ………………………..

A Name of the Candidate

01 Date of Registration
02 Registration Number
03 Name of the Research Supervisor and 04 Tentative title of Ph.D. Thesis
Address

05 Recognized Discipline
06 Course work Completed
07 Will be appearing
08 India/ Foreign Candidate Annual fee attached
Yes / No
DD/ Challan
B Progress Report
01 Periodical Discussions held (No. of meetings)
02 Whether a diary is maintained
03 Seminars / Lecture Name Venue Date
Programme attended

04 Conference/ Name Venue Date

Symposium attended

05 Paper Presented (Attach Certificate copy / Copy of Published Article)

06 Manuscript submitted for Publication details
07 Research Paper Published details
08 Books written or published details
09 Any other details
10 Remarks of Research Supervisor
Note : Candidate is required to submit the progress report once in a year within one month of completion of the year.

Signature of the Candidate Signature of the Research Supervisor (with Seal)

Signature of the Chairman/ Director

x
 ªÉÄʸÀÆgÀÄ «±Àé«zÁ央AiÀÄ
UNIVERSITY OF MYSORE
Research Centre, Pareeksha Bhavan, Mysuru – 570005, Karnataka, India

APPLICATION FOR CHANGE OF GUIDE / TOPIC

01 Name of the Student

02 Enrollment Number and Date

03 Subject

04 Centre in which enrolled

05 Full address

06 Change required (Guide / Topic)

07 Change for

From To

08 Mode of Payment (Demand Draft in favour of “The Finance Officer, University of

Mysore, Mysore” issued by any Nationalised Bank Payable at Mysore or Challan
remittance)

DD No. / Challan No. Date Amount Name of the Bank Place of the Bank

Note :
1. Name of the Student with Enrolment No. should be written on the reverse side of the
Demand Draft.
2. Student should enclose “No-Objection Certificate” from the guide.
3. Consent and Declaration letter from the guide.

Date :
Place : Signature of the Candidate

Signature of the Guide Signature of the Chairman/ Director

xi
 ªÉÄʸÀÆgÀÄ «±Àé«zÁ央AiÀÄ
UNIVERSITY OF MYSORE
Research Centre, Pareeksha Bhavan, Mysuru – 570005, Karnataka, India

APPLICATION FOR Ph.D. COURSE WORK EXAMINATION

Affix recent
Appearing Subject : ..................................................... passport size
photo
01 Name of the candidate Attested by the
HOD
(in Block Letters)

02 Name of the Guide

03 Name of the Research

Centre

04 Address for Communication

05 E-mail ID

06 Provisional Registration Date

07 Date of Enrolled for Course work

08 Date of Birth 09 Gender 10 Category

11 Details of fee paid

Name of the Bank Challan / DD Date Amount

Number

Signature of the Signature of the Signature of the Chairman/

Candidate Guide Head of the Institution

xii
 ªÉÄʸÀÆgÀÄ «±Àé«zÁ央AiÀÄ
UNIVERSITY OF MYSORE
Research Centre, Pareeksha Bhavan, Mysuru – 570005, Karnataka, India

Ph.D. COURSE WORK EXAMINATION : ......................................

ADMISSION CARD
(To be retained by the Candidate to use on the day of Examination)

DATE OF EXAMINATION : ………………………………….

Roll No. :

Name : Affix recent

passport size
photo
Subject : Attested by the
HOD

Exam Centre :

Timings Signature of the Invigilator

Important Note:
1. The candidates will not be allowed to examination hall without this admission card. The candidates should also
bring along one valid photo ID proof.
2. Electronic device/cellular phone/mobile/pager/calculator/log tables etc. shall not be allowed in the Examination
Hall/Room.
3. The candidate will be permitted to appear at the allotted venue of the Ph.D. examination only.
4. The request for change of Test Centre/Venue of test will not be entertained.
5. No TA will be paid for appearing in the examination.

Signature of the Signature of the Chairman/

Candidate Head of the Institution

xiii
 ªÉÄʸÀÆgÀÄ «±Àé«zÁ央AiÀÄ
UNIVERSITY OF MYSORE
Research Centre, Pareeksha Bhavan, Mysuru – 570005, Karnataka, India

APPLICATION FOR Ph.D. COURSE WORK MAKEUP EXAMINATION

Affix recent
Appearing Subject : .............................................................................. passport size
photo
Attested by the
Paper : .............................................................................. HOD

01 Name of the candidate (in Block

Letters)

02 Name of the Guide

03 Name of the Research Centre

04 Address for Communication

05 E-mail ID

06 Provisional Registration Date

07 Date of Enrolled for Course work

08 Date of Birth 09 Gender 10 Category

11 Details of fee paid

Name of the Bank Challan / DD Date Amount

Number

Signature of the Signature of the Signature of the Chairman/

Candidate Guide Head of the Institution

xiv
 ªÉÄʸÀÆgÀÄ «±Àé«zÁ央AiÀÄ
UNIVERSITY OF MYSORE
Research Centre, Pareeksha Bhavan, Mysuru – 570005, Karnataka, India

Ph.D. COURSE WORK MAKE-UP EXAMINATION : ....................................

ADMISSION CARD
(To be retained by the Candidate use on the day of Examination)

DATE OF EXAMINATION : ………………………………….

Roll No. :

Name :
Affix recent
Subject : passport size
photo

Paper : Attested by
the HOD

Exam Centre :

Timings Signature of the Invigilator

Important Note:
1. The candidates will not be allowed to examination hall without this admission card. The candidates should also
bring along one valid photo ID proof.
2. Electronic device/cellular phone/mobile/pager/calculator/log tables etc. shall not be allowed in the Examination
Hall/Room.
3. The candidate will be permitted to appear at the allotted venue of the Ph.D. examination only.
4. The request for change of Test Centre/Venue of test will not be entertained.
5. No TA will be paid for appearing in the examination.

Signature of the Signature of the Chairman/

Candidate Head of the Institution

xv