For candidates worked in any P.G. Department of F.M. University as place of research and submitting thesis:
FAKIR MOHAN UNIVERSITY
Examination of Thesis for Ph.D. Degree 20 …….
NO DUES CERTIFICATE
To
The Controller of Examinations
Fakir Mohan University
[Through Proper Channel]
I declare that there is no outstanding dues against me for the academic session ……. ……. to …… …. during the tenure of my studentship.
Enclosed please find my identity card
Kindly issue me a No-dues certificate
Date: Signature in full
Name (in block letter):..…………………………………………..
Course: Master Degree/ M. Phil. / Ph. D./ D. Litt./ D. Sc./ LL.D
Department:…………………………………………………………
Head of the Department / Department Librarian / Guide (for Ph D )No due/ dues, if any / No due/ dues, if any / No due/ dues, if any
Hostel warden / Dean Students’ Welfare / Central Library
No due/ dues, if any / No due/ dues, if any / No due/ dues, if any
For all candidates submitting thesis:
FAKIR MOHAN UNIVERSITY
Examination of Thesis for Ph.D. /D.Sc./D.Litt./LL.D./Other Degree 20 ……. Application
To
The Controller of Examination
Fakir Mohan University
Vyasa Vihar, Nuapadhi
Balasore – 756020, Odisha
Sir,
I request permission to submit a THESIS on ……………………………………………………………………… ……………………… ……………………………………………………………….. …………………….. … …. ……………………………………………………………………………………….. ……………………………… …………………………………………………………………………………………………………………………
for the degree of Doctor of Philosophy / Literature / Science / Law.
The fee of Rupees …………… (……. ………………… ………………………………………………..
………………………………………………………………………………………………………………………………………………………..) and ………. ….. copies of Theses are forwarded herewith.
If any statement made by me in the application be found to be not true, or if it appears that, in the opinion of the University, I have in any way contravened the provisions the provisions of the University Rules and Regulations relating to the Ph.D. / D Litt./ D. Sc. / LL.D. examination or if any Plagiarism is founded in the Thesis my admission to the Examination will be liable to be cancelled by the University.
I am
Sir,
Yours Obediently
Signature of the candidate (in full) ……………………………….. ………………………………………………..
Present Address ………………………………….. ……………………………………………………………….. Dist. …………………………… State…. …………………… Pin ………………….. Tel:...... Mob: …………………………….. Email: …………………… …………….……………………………………….. …………………………………………………………………………………………..
Permanent Address ……………………………………………………………………………………………….. Dist. …………………………… State…. …………………… Pin ………………….. Tel:......
CERTIFICATE
I certify that the above-named candidate has satisfied me, by the production of a certificate of a competent authority that he/she has passed the Master’s Degree Examination with required percentage of marks of an Indian University incorporated by any Law for the time being inforce or an Examination recognized as equivalent thereto which qualifies him/ her for admission to the Ph.D. / D Litt./ D. Sc. / LL.D. examination; that he / she has pursued a course of Research as prescribed by the University for the Ph.D. degree (if application as per the regulation under which the candidate has registered); that his / her conduct has been good; that he / she is a fit and proper person for the Degree.
…………………………………….. ……………………………………….
Head of the Department/Head of the College/Institution Guide …………………………….
[As per the place Of Research]
Date……………………………
Seal …………………………….
Certified that Sri / Smt. …………………………………………….. ……………….………………………………
Carried out research at ………………………… with registration for Ph.D./D.Litt./D.Sc./LL.D. under
Fakir Mohan University, His studentship is valid upto ………/ …………/ 20 ….. The title of the Thesis as mentioned by the candidate is correct.
D Assist. Deputy controller of Examinations
Fakir Mohan University
For all candidates submitting thesis:
Ph.D. /D.Sc./D.Litt./LL.D. Examination
PARTICULARS TO BE FILLED IN BY THE CANDIDATE AT THE TIME OF SUBMISSION
1. Name in Full :
a. In English [bock letters]
b. In Odia Scripts :
2. Sex:
3. Date of birth:
4. Registration No:
5. Date of registration for Ph.D.
6. A certificate of the pre-submission seminar to be required to this office at the time of submission of the thesis (to be collected from the concerned University authority, if required as per the regulation under which registered)
7. Address [a] Present:
[b] Permanent
[c] Native District and Town or Village / Police Station
8. Name and address of Father or the Guardian or in the case of a married women the Husband:
9. The date of passing and the Roll Number of the M.A./ M. Sc./………… Examination (from which University) …………………………………………………………….. ……………………………………………………………………………
10. [a] Nationality
[b] Whether belongs to Scheduled Caste / Tribe
11. The candidate shall indicate how far the thesis embodies the result of his / her own research and in what respects his / her investigations appear to him / her to advance the study of the subject of his/ her thesis.
Signature of Guide/Co-Guide (if any) Signature of the Candidate
Enclosure:
i] No dues certificate from the Head of the Place of Research
ii] Pre submission Seminar Certificate (If applicable as per the regulation under which registered)
iii] Synopsis of the thesis ( 5 copies duly signed by the candidate and approved by the Guide)
iv] Migration Certificate (if migrated from other University), if not submitted earlier
V] A declaration from the guide that the list of examiners in the prescribed proforma submitted to the University by the guide separately without disclosing the identity of guide/co-guide, if any and the candidate in the examiner listy in the prescribed proforma.
For all candidates submitting thesis:
Date:
DECLARATION TO BE GIVEN IN THE SYNOPSIS OF THE THESIS
This is to declare that the present “SYNOPSIS” is based on the material of the thesis entitled ……………………………………… ………………………………………………….. ……………………………..
……………………………………… ………………………………………………….. ……………………………..
submitted by the undersigned ……………………………………………………… for the award of the degree of Doctor of Philosophy/ Literature/ Science/ Law /………………………..of Fakir Mohan University, Vyasa Vihar, Odisha, India.
[Name of the candidate]
With address, telephone and email
Details of Guide & Co-Guide, if any
(With address, telephone and email)
Format of Front page of the thesis:
Title in full: (Example below)
MINING PHOTOTROPHIC PROTEOBACTERIA FOR QUINOES AND THEIR BIOPROSPECTING
A THESISSUBMITTED
TO FAKIR MOHAN UNIVERSITY IN FULFILMENT OF THE REQUIREMENTS FOR
THE DEGREE OF DOCTOR OF PHILOSOPHY
IN…(Example: ENVIRONMENTAL SCIENCE)
IN THE FACULTY OF
Any one of these relevant faculty: HUMANITIES AND SOCIAL SCEINCE
SCIENCE AND TECHNOLOGY
BUSINESS STUDIES AND MANAGEMENT
PEDALOGICAL SCIENCES
LEGAL STUDIES
University logo
Submitted by
Name in full:
Year:
Place of Research (Example : Department of English, F.M. Autonomous College, Balasore)
Affiliated to FAKIR MOHAN UNIVERSITY, BALASORE-756020, ODIDHA, INDIA
Declaration by the candidate in the thesis:
Name of the candidate
Address: as per the place of research
Present address: with pincode, telephone and email
DECLARATION
I hereby declare that the research work presented in this thesis entitled “…………………………………………………………………… ” is original and was carried out by me under the supervision of ………………… (If co-guide approved name of the co-guide to be given), at………………….(Place of research to be mentioned).
The work is original and has not been submitted for any degree/Diploma of this or any other University
Signature of the Candidate
with place and date
Registration no. and date
Signature of the
Guide/Co-Guide (if any)
(With date and seal)
Signature of the Head of the Department/
College/Institution where with work was carried out
(With date and seal)
Certificate of the Guide/Co-Guide (if any) to be enclosed in the thesis:
Name of the Guide/ Co-Guide, if any, then both to be given as below
Address: as per the place of research
Present address: with pincode, telephone and email
CERTIFICATE
This is to certify that the thesis entitled “………………………” that is being submitted by …………………in fulfillment for the Award of DOCTOR OF PHILOSOPHY IN (……….. SUBJECT TO BE MENTIONED) in the faculty of………………(the relevant faculty to be mentioned) to Fakir Mohan University, Balasore is a record of bonafide work carried out by him/her under my guidance and supervision (If co-guide, under our guidance and supervision).
The results embodied in this thesis have not been submitted to any other University or Insttiute for the award of any degree or diploma.
Signature of the Guide
with place, date and seal
Signature of the
Guide/Co-Guide (if any)
(With place, date and seal)