BHAGWANT UNIVERSITY, AJMER

BURET - 2018
Application Form
(Date of Examination: Sunday, 7th Jan, 2018)
Form No.________________________ Registration No._________________________
(For office Use) (For office Use)
Program applied for: M.Phil Ph.D. Department:........................................
(Please fill in the Application Form in BLOCK LETTERS)
Name (Mr./Mrs./Ms.) _________________ _________________ ______________
Surname First Name Middle Name
Recent Passport
Father’s Name _________________ _________________ _________________ Size Photograph
Surname First Name Middle Name

Mother’s Name _________________ _________________ _________________

Surname First Name Middle Name

Date of Birth Nationality_________________

Date Month Year Religion _________________

Caste Category: SC/ ST/ OBC/ General

Address: ___________________________________________________________________________

____________________________________________________ Pin

Landline________________ _____ _________Mobile_______________________________________

Office: _______________________________________________________________________________

____________________________________________________ Pin

Landline______________________________ Mobile_______________________________________

Email ID ____________________________ Aadhar No. ____________________________________

Marital Status: Single Married Gender: Male Female

Hostel Facility Required: Yes No

Educational Qualifications:
Examination Institution Board/University % Year Subject
Secondary

10+2

Graduation

Post graduation

Any other
qualification
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Extra-curricular activities and honors received (if any)__________________________________
______________________________________________________________________________________

Entrance Fee Paid Details: Rs. 1100 paid vide ……………………………………………………..

DECLARATION BY CANDIDATE

I, Mr./Mrs./Ms._________________________________________________________hereby declare that

the information furnished in this form is true to the best of my knowledge and belief. I am submitting this

application, with the understanding that I am eligible for M.Phil/ Ph.D. admission as per UGC norms. If

later, I am not found eligible as per UGC norms, my candidature may be cancelled/ terminated by Bhagwant

University Ajmer.

Date:____________________ Signature of Applicant

Kindly forward the duly filled application form along with the DD of Rs. 1100/-in favor of 'BHAGWANT
UNIVERSITY' payable at Ajmer, by speed post/courier/personal visit on the address given below: (Latest
by Monday, 18th December, 2017)

Bhagwant University
Sikar Road,
Ajmer (Rajasthan)-305004
Mob.-+91-9928144442/ 43

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 BHAGWANT UNIVERSITY, AJMER
BURET - 2018
CENTRE’S COPY

Roll No.__________________________

Name of Candidate:________________________________________ Self Attested

Passport size
Father’s Name: ___________________________________________ photograph

Address for Correspondence:________________________________

______________________________________________________________________________________

Choice of Centre by the Candidate:______________________________________________________

Centre allotted by the University:_________________________________________________________

Date & time of Test: SUNDAY JANUARY 07, 2018, 11.00 AM

Signature of Candidate Coordinator (BURET-2018)

BHAGWANT UNIVERSITY, AJMER

BURET - 2018
CANDIDATE’S COPY
Roll No.__________________________

Name of Candidate:____________________________________________ Self Attested

Passport size
Father’s Name: _______________________________________________ photograph
Address for Correspondence:____________________________________

______________________________________________________________________________________

Choice of Centre by the Candidate:______________________________________________________

Centre allotted by the University:_________________________________________________________

Date & Time of Test: SUNDAY JANUARY 07, 2018, 11.00 AM

Signature of Candidate Coordinator (BURET-2018)