PRESIDENCY UNIVERSITY

Ph.D. Program August – 2019

APPLICATION FORM for Ph.D. Admission

 Full Time  Part Time  Part Time (Internal)*

* Employees of Presidency Group of Institutions only
Affix
Tick the appropriate box
Passport Size
 School of Engineering  School of Management Photograph
 School of Arts & Design  School of Commerce
Name of the candidate :
(in BLOCK LETTERS)

Gender :  Female  Male  Transgender

Mobile No (Candidate) :
Primary email ID :
Alternate email ID :
Date of Birth (DD/MM/YYYY) :
Nationality :

Tick the relevant Category :  General  SC  ST  OBC

Summary of Proposed Research Work :  Enclosed
NOC & Other Relevant Certificates (For
:  Enclosed
Part Time Candidates).

Address for Communication :

Parent / Guardian Details

Father Mother Guardian

Name
Mobile No
email ID
Occupation
Annual Income

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Local Address Permanent Address

Area Area
City State City State
Country PIN Country PIN
 Tick if same as Address for Communication
Academic Record
Sl. Board /Degree Institution / Period of Date of Aggregate Percentage/CGPA Division /
No. University Study Completion / (For CGPA mention Scale, eg. Class (if
Award of 7-point, 10-point, etc.) any)
Degree

Academic Achievements
Sl. No Other Academic Achievements Year
(NET / JRF / Awards / Publications)

Experience Information (As Applicable)

Sl. No. Organization Designation From To Experience (in Salary
(Date) (Date) Years)

CHECKLIST OF DOCUMENTS
(Each two sets)
th
1. 10 or Equivalent Marks Card
2. All Marks Sheets / Grade Cards
3. Master’s Degree Certificate
4. NOC from Employer (For Part Time Candidates)
5. Proposed Research Summary (500 words)

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 Non-refundable Application Fee
Non-refundable Application Fee Rs. 1000/-
Payment Mode :  DD  Online Transfer
A Demand Draft (DD) for Rs. 1000/- No: _____________________ drawn on __________________
Bank, dated ___________ in favour of “PRESIDENCY UNIVERSITY” payable at Bangalore.
Or
Transaction ID: ___________________________ NEFT Transfer to the Savings Bank A/c:
11890100132860, IFSC Code: FDRL0001189, PRESIDENCY UNIVERSITY, Federal Bank, Gandhi
Nagar, Bangalore – 560 009.

DECLARATION BY THE CANDIDATE

I hereby declare that the entries made by me in this application form are true in all respects and if any entry or
information is found to be false, this shall entail automatic cancellation of my admission besides rendering me
liable to such actions as the University may deem appropriate.

Place:
Date: Signature of Candidate

Last Date for Submitting the Completed Application is 15th July 2019.
The Date of PhD Entrance Test & Interview: 27th July 2019.
Send the filled-in application forms to The Registrar, Presidency University, Itgalpur, Rajanakunte,
Bangalore -560 064.
Please write on top of the envelope as, "Application Form for Ph.D. Admission – Aug 2019"
FOR OFFICE USE ONLY

Date of receipt of Application ______________________ Receipt No _________

Acknowledgement sent on __________
Documents Submitted 1. ______________________________________________
2. ______________________________________________
3. ______________________________________________
4._______________________________________________
5._______________________________________________
6._______________________________________________
Application verified by ____________________________Date _______________
Test Score____Prescribed Fee ____ Selected / Not Selected____________________ Decision
notified to applicant on ____ Fee Paid____________________________
Date______ Place__________

Signature of Admission Officer

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