9/28/2017 Admission Acknowledgment Receipt

Application Form for Ph.D (Engineering) Admission at AcSIR

Headquarters: Training & Development Complex, CSIR Campus,
CSIR Road, Taramani, Chennai - 600113
Coordination Office: CSIR-Central Road Research Institute,
CRRI P.O., Delhi-Mathura Road, New Delhi - 110025

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Official Information
Form No : 22628
Session : Jan-2018
Programme Applied For : Ph.D (Engineering)
CSIR Lab Preferences :
(1)CSIR-National Aerospace Laboratories (CSIR-NAL), Bengaluru
(2)CSIR-Structural Engineering Research Centre (CSIR-SERC), Chennai
(3)CSIR-Central Mechanical Engineering Research Institute (CSIR-
CMERI), Durgapur

Currently working in CSIR Lab? : No

Relevant research/teaching experience in
:0
Months
No. of papers published/accepted in SCI
:0
journals
Total impact factor generated :0

Personal Information
Name : LOKESHBABU M
Category : OBC
Are You Physically Handicapped ? : NO
Gender : Male
: Address :Dr no: 7-1725/2 Near mayuri hotel, Lepakshi nagar, Kalikiri
Permanent Address : Country :INDIA State :Andhra Pradesh
: City : PILER Pin Code :517234
: Address :Dr no: 7-1725/2 Near mayuri hotel, Lepakshi nagar, Kalikiri
Present Address : Country :INDIA State :Andhra Pradesh
: City : PILER Pin Code :517234
Nationality : INDIAN
E-mail : lok.311@gmail.com
Mobile No. : 9916410832
Alternate Mobile No : 7829909290
Phone No. :-
Date of Birth : 14/06/1989
Father's Full Name : M.radhakrishnaiah
Mother's Full Name : P.Laskhmi devi

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9/28/2017 Admission Acknowledgment Receipt

Educational / Professional Qualifications:

Qualification Stream/Subject(s) CGPA/% Evaluation System Year of Passing Board/University
10th ssc 83.60 Percentage 2004 AP SSC BOARD
10+2 PCM 79.30 Percentage 2006 AP STATE IPE BOARD
B.Tech Mechanical engineering 61.42 Percentage 2010 JNTU ANATAPURAM

Fellowship Details:
Registration/Ref.Letter Date of Exam/Ref.Letter
Fellowship Subject Rank Percentile Score
No. Date
Project Sponsored
sixsigma no 01/12/2009 0 0 0
Candidates

DECLARATION

I LOKESHBABU M confirm that I have submitted only one application for the online admission process and declare that all
the statements made in this application form are true, complete and correct to the best of my knowledge and belief and
nothing has been concealed/ distorted. I understand that in the event of any information being found false or incorrect
at any stage, my candidature/ admission is liable to be cancelled/ terminated without notice.

Place: ________________
Candidate's Signature
Date: ________________ (Lokeshbabu m )

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9/28/2017 Admission Acknowledgment Receipt

Only for Industry/ Project Sponsered Candidates

Endorsement by the Competent Authority of the Employing Organization

The facts stated in this application have been verified and found correct. This organization/ department has no
objection in Mr / Ms LOKESHBABU M applying for M. Tech./Ph.D. programme of AcSIR in
(specialisation/cluster)________________________________ at CSIR-
___________________________________________ (lab) as a sponsored candidate.

Only for Project Sponsered Candidates

Project Name Lab Name Project Start Date Project Completion Date

I endorse that the organisation agrees to all the academic and administrative requirements for completion of the
course by the student.

Signature
Date: _____________________
Name & Designation
Place: _____________________
Seal of Organization

Note: Please do not send this form to us, you will be required to bring it only in case you are called for interview.
However in case of Industry/Project sponsored candidates, need to send the application form to the respective
coordinator of the lab applied with due endorsement from the competent authority of the sponsoring organization.
Checklist for Appearing in Interview, if Short-listed:

1. Two Printed copies of the submitted application form

2. Two copies of their recent passport size photograph
3. Originals along with two copies of each of the following documents:
1. Post-graduate or Graduate provisional or degree certificate
2. Detailed mark sheet(s) / transcripts showing the final CGPA or percentage of the above
3. Matriculation/secondary school certificate (in support of date of birth).
4. SC/ST/OBC/PH candidates are required to produce the requisite "Certificate" issued by the
competent authority.
5. Award of Fellowship related document

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