City Office: Plot No. 2167/A
Opposite IDBI Bank, Ashok Nagar,
Ranchi – 834002, Jharkhand

Application Form for Admission

The PhD Program in Management
(Part-time)
- 2017

Admissions Officer :
The ICFAI Univeresity Jharkhand,
Campus Address
Plot No. 2065,
Daladali Chowk, Simalia,
Near Kathal Mode,
Ranchi, Jharkhand - 835222
Ph : 1800 425 0767
Email : ugpgadmissions@iujharkhand.edu.in
website : www.iujharkhand.edu.in

   1. NAME OF THE CANDIDATE (use Capitals Only) [As it appears in the School certificates]
  Prefix :

Please upload your recent color Photograph (JPG / GIF
format only)
(Size 3.5 cm X 4.5 cm)
(File size not more than
25-30 KB)  

  Name :



(As it appears in the School Certificates)

  Gender  :

 
   2. PERSONAL DETAILS (use capitals only)

Date of Birth

:

Mobile

:

E-mail

:

Tel (Res)

:

STD Code

Number 

Mailing Address

:

City

:

  

State

:

   

Pin

:

Permanent Address

:

City

:

  

State

:

  

Pin

:

   3. ACADEMIC QUALIFICATION OF THE CANDIDATE

a.

Examination Passed

Name of Institution / University

Month of Passing

Year of Passing

Period (Year)
Starting Year

Period (Year)
Ending Year


Titile of Degree/ Certificate

 

Mode of Study

% of Marks

X

XII

Graduation

Post Graduation

Others (Eg. CA, M.Phil, etc)

Note : If it is an affiliated college, please mention the name of the University it is affiliated with.

   4. Work Experience

(Attach certificate of work experience. Please indicate special achievements, if any).

Employer's Name and Address

Period of Service
(i.e Date of Joining & Date of Leaving)
(ddmmyy for ex: 051214)

No. of Years

Designation

Area of Work

 
 
 
Total Experience in Months:  Teaching   Non Teaching
   5. AWARDS AND RECOGNITIONS IN ACADEMICS AND SPORTS

List awards, distinctions, honors and scholarships (academic, extracurricular, community services,NCC, etc).

Awards

Year

Basis

  6. HAVE YOU PUBLISHED ANY ARTICLES OR RESEARCH PAPERS ?

Yes        No         If  "Yes" , Please give details and enclose copies of the same.

   Title of Article :   

Journal / Magazine  :       Date :  

  7. HAVE YOU PRESENTED PAPERS AT ANY SEMINARS / CONFERENCES / WORKSHOPS ?

Yes        No         If  "Yes" , Please give details.

   Topic of Seminar/Conferences/Workshops  :   

Organized by    :           Date  :   

  8. HAVE YOU WRITTEN / EDITED ANY BOOK ?

Yes        No         If  "Yes" , Please give details.

   Title of Book  :   

Publisher   :           Date  :   

  9. NAMES AND ADDRESSES OF TWO REFERENCES (NOT BEING RELATIVES)*

Reference Information

Reference 1

Name

Qualifications

Occupation

Please Specify  :

Designation

Organization
& Address

City

Pin

Ph (O)

STD Code

Number 

Mobile

Personal
E-mail

Company Website

 

Reference 2

Name

Qualifications

Occupation

Please Specify  :

Designation

Organization
& Address

City

Pin

Ph (O)

STD Code

Number 

Mobile

Personal
E-mail

Company Website

  10. If you are current employee of any ICFAI sponsored organization, mention the particulars. The Head of the Organization should forward your application.
 Employer  :    
 Designation of the Employee  :    
Place   : 
Forward by (Name)    :   
Designation   :

(The Head is requested to enclose a letter commenting on the suitability of the candidate for this Program)     

  11. DOMICILE STATUS

Domicile in State of Jharkhand         Non-Domicile

(If yes, please enclose the Domicile Certificate issued by the competent Authority)
     

   12. SOURCE OF CONTACT (Please select or mention how you came to know about ICFAI)

Search Engine (Google/Yahoo/Bing/Others)      Website    Social Media (Facebook/Twitter/Other)     New Paper Article

Newspaper/Magazine advertisements       Electronic Media (FM/TV)       Education Fairs       Friends      Events of IUJ

Alumni/Students of IUJ         Teachers        Others       

   13. WHY DO YOU WANT TO PURSUE THE Ph.D. PROGRAM ?


(Max 500 Characters)

  14. PLEASE INDICATE YOUR AREA OF INTEREST FOR RESEARCH

Finance          Marketing         HR / OB        Others       

  15. SPECIFY TOPIC / SUBJECT YOU ARE INTERESTED TO DO RESEARCH ?


(Max 500 Characters)

  16. WHY ARE YOU INCLINED TO DO RESEARCH IN THE ABOVE AREA ?


(Max 500 Characters)

   17. MODE OF PAYMENT
Payment Mode
:
   18. DECLARATION


I certify that I fulfill all the requirements of the part-time Ph.D. Program of the ICFAI University, Jharkhand as given in the Prospectus and Application Material and agree to abide by the same. I understand that these rules are only indicative and the complete list of rules and regulations as updated from time to time will be given to me on my enrollment in the form of Student Handbook / and / or any other communication issued from time to time. I also understand that the ICFAI University, Jharkhand reserves the right to change/modify the rules and regulations from time to time and I agree to abide by the same. I agree to pay the fee as per the schedule of fee payment stipulated. I understand that in case I withdraw from the program after 15 calendar days, from the date of registration, for reasons whatsoever, I will not be entitled to claim any refund of amount paid to the ICFAI University, Jharkhand. In the event of any dispute, I hereby declare and state that, I will not approach any Court of Law and/or seek redressal under the provisions of the Consumer Protection Act 1986 without first exhausting the remedy from the Arbitration. I understand that the jurisdiction for all disputes (if any) relating to the ICFAI University, Jharkhand is Ranchi. I hereby declare that the information provided by me in the Application is true and correct to the best of my knowledge. I Agree that I have read, understood and agreed to the rules and regulations of the ICFAI University, Jharkhand including my financial responsibilities.



I Agree