Application For Recognition As Supervisor For Phd Program

This application should be filled by the applicant and submitted to the office of the Dean, WBUHS, through the Head of Department and the Head of the Institute affiliated to the University.

Name of the Applicant

Designation

Name of the Department

Name of the Institution

Phone No

Date of Birth

Age Proof. ⓘ

Address of the College / University / Institution where the applicant is currently working including phone No, Fax, E-mail etc

Permanent Address of the Applicant

The Faculty & Discipline in which the applicant is seeking recognition as a Supervisor

Select Faculty

Select Discipline

Educational qualifications of the applicant (supporting documents must be provided)

P.G. Degree

Subject / Discipline

Year of Passing

Name of the University & College

PhD

Subject / Discipline

Year of Passing

Name of the University & College

Any Other Post PG Higher Degree

Subject / Discipline

Year of Passing

Name of the University & College

Teaching And Research Experience

Duration of service rendered as Professor, Associate Professor, Assistant Professor, Tutor, or Scientist in Grades D, E, F, and G.

Position

Years

Months

PG Teaching Experience in Total (Years)

No. of PhD research scholars being supervised by the applicant till date

Full Time

Part Time

Awarded

Awaiting award

Research papers published in peer-reviewed, indexed journals after obtaining a PhD or during professorship (provide a separate list)

Total

Last 5 years

Research projects currently being undertaken (Field of Research / Specialized area of Research)

Posts, Offices and memberships held in Academic Bodies / Reviewer of papers in Academic Journals etc.

National / International Conference / Seminar / Symposium / State Level National Abroad Workshop attended / conducted & any other current research activities

State Level

National

Abroad

Are you a PhD Supervisor in any other University?

Yes No

Note: The application (for recognition of PhD Supervisor) should be submitted with required supportive documents. Applications received without evidence will not be considered.

Date : 05-11-2026

Signature of the Supervisor ⓘ

Signature of the Head of the Department with seal and date

Signature of Principal or Head of the concerned Institute with seal and date