Annexure I & II (DCM3205) - Version 02
Annexure I & II (DCM3205) - Version 02
Annexure I & II (DCM3205) - Version 02
DECLARATION
I hereby declare that this project synopsis is an original work carried by me and has not
been/will not be submitted to any other University for fulfilment of any course of study.
Place:
Date:
(*Filled in application forms to be signed by both student and the Guide. Forms must be
scanned in either .pdf/.doc format and submitted through the LMS student’s Login. For
uploading, please refer section 2.1.3 of this document)
1. Name:
2. Date of Birth:
3. Present Employer: Affix Your Latest Photo
4. Designation:
5. Contact Details:
i) Residential Address:
ii) Office Address:
iii) All communications to be sent to: Residential/ Official address (tick anyone)
iv) Contact No.:
v) E-mail id:
10. Education Qualification (start with highest qualification): (Please attach photocopies of
degree certificates)
S. No. Name of Specialization Year of Institution/University Class
the Degree Passing Obtained
I hereby declare that the information provided by me is true. I agree with the rules and
regulations given by the University.
Signature (Proposed Guide)
(FOR OFFICE USE)
Signature Signature
(Faculty in-charge) (Project Steering Committee)
(Note: Filled in Registration forms must be scanned in either .pdf / .doc format and
submitted along with credentials (Scanned copy of Degree Certificates, PAN Card (for
Domestic Guide), Passport (for Foreign Guide) and Experience Certificates of the proposed
guide) on LMS portal- link).