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Application Form for Entrance Test

Ph.D

INSTRUCTION 1. Use BALL POINT Pen only. 2. Application Form should be filled in CAPITAL Letters. 3. Tick ( ) at the relevant box. 4. Write NA where not applicable 1. Ph.D Programme applied for in the field of: Arts, Humanities & Social Sciences Science & Technology Commerce Fashion Technology Branch: 2. NAME OF THE CANDIDATE

Signature of the Candidate (in Box)

Business Administration Hospitality & Tourism Mass Communication Education

Date of Birth

3. FATHERs / HUSBANDs NAME

Occupation CONTACT NUMBERS Telephone No. STD Code E-MAIL ADDRESS OF FATHER / HUSBAND Mobile No.

4. MOTHERs NAME

5. PERMANENT ADDRESS

City: CONTACT NUMBERS Telephone No. STD Code

Pin Code: Mobile No.

E-MAIL ADDRESS

6. CORRESPONDENCE ADDRESS

City: CONTACT NUMBERS Telephone No. STD Code

Pin Code: Mobile No.

E-MAIL ADDRESS

7. GENDER
Male Female

8. CATEGORY
Gen ST SC OBC

9. NATIONALITY
Indian Others

If Other, please specify___________________

If Other, please specify___________________

10. ACADEMIC INFORMATION (Previous Educational Qualifications) Course/Program Session University/Board (Year to Year) Name of the Institute Marks obtained/ Branch/Stream Percentage

11. ACADEMIC / RESEARCH EXPERIENCE (if any) S. No. Position Organisation Period Assignment

12. APPLICATION FEE DETAILS Amount Rs. Bank: 13. DOCUMENT INFORMATION (Please tick the items enclosed with the application form)
10th standard Mark Sheet 10th standard passing Certificate 12th standard Mark Sheet Graduation Mark Sheets Graduation Degree Migration Certificate Post-Graduation Mark Sheets Post-Graduation Degree Work Experience Certificate (if any) Research Credentials (if any) 2 coloured passport size photographs Demand Draft

DD No.

Date:

I................................................ hereby declare that all the statements made in this application are true, complete and correct to the best of my knowledge and belief. In the event of any of the information being found false or incorrect or any ineligibility being detected before or after the test, my candidature is liable to be cancelled and action will be initiated against me.

Date: Signature: Place: