Visvesvaraya Technological University

Jnana Sangama, Belagavi – 590 018, Karnataka State, India

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APPLICATION FOR ADJUDICATION OF Ph.D THESIS

(Full Time/Part Time)

1. Name of the Candidate:______________________________

2. U S N:

3. Research Centre: ________________________________

(Name of Dept.& Institution)

4. Title of the Dissertation:______________________

(In case the title of the thesis is changed, approval letter from the Registrar to be enclosed)

5. Area: Electrical Engg /Mechanical Engg /Civil Engg/General Science

Synopsis: Two copies to be enclosed duly signed by the candidate, Guide/ Co-Guide and Head of the
Research Centre (2 copies of the synopsis to be submitted by the candidates shall be minimum of 30-40 pages in an A4 Size. The synopsis will indicate the work
carried out by the candidate giving appropriate references. The content of Synopsis should indicate roughly the summary of the planed thesis chapter wise)

6. Subjects / Courses taken & passed

Sl. Sub-Code Subject Title Month& Year of

No Passing
01
02
03
04
05*
06*

7. Date on which the results of Comprehensive Viva – Voce completed. (A copy of

comprehensive viva – voce result sheet to be enclosed)

CERTIFICATE

I hereby declare that the work to be submitted in the dissertation is in line with the
synopsis and title mentioned above. The work to be submitted is the original work of
mine and has not been submitted by me anywhere for the award of any other degree
and to the best of my knowledge has been not carried out by anybody else and
reported.

Place:
Date:

Signature of the Candidate