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APPLICATION FORM

Note:
Affix Recent
1. Applicant must ensure that he/she fulfills the minimum eligibility conditions for the Programme,
Passport Size
before applying.
Photograph
2. All the particulars must be filled in by the candidate in his/her own hand writing.
3. Please complete the form in CAPITAL LETTERS using blue or Black ball point pen.

Domain Applying for


Discipline Name

First Name
Middle Name
Last Name

Father's Name

Mobile Number

Mother's Name

Mobile Number

Date of Birth Gender Nationality


D D M M Y Y Y Y Male Female Indian
Other (Please Specify)

Correspondence Address
Address

City
District
State Pin code
Candidate's Mobile Number
Email ID

EDUCATIONAL QUALIFICATIONS
Class Board/University Stream/Discipline Year of Passing Percentage of Marks
X
XII
Graduation
Post - Graduation
Any Others, Specify
If you have qualified UGCNET/ CSIR(JRF) Examination/ SEET/ GATE/ Teacher Fellowship Holder or
M.Phil, please give the details below:

Name of the Percentile/ Validity Period


Passing Year Remarks
Examination % age (if applicable)

Teaching/ Research/ Industry Experience:

Name and Address Nature of Experience Designation From To


of the Organization Industrial/ Research

DECLARATION BY THE CANDIDATE

"I, .................................................. certify that the information provided is true and accurate to the best of my
knowledge and that I will furnish proofs as and when required by authorities of Sanskriti University"

Date: ...................... Student Signature