CENTRAL UNIVERSITY OF HARYANA

(Established vide Act 25 (2009) of Parliament)

VILLAGES (JANT-PALI), MAHENDERGARH, HARYANA

Temporary Camp Office: Govt. B.Ed. College Building, Narnaul (Distt. Mahendergarh) Haryana-123001

TEL: 01282-255002, 255003;

Website: www.cuharyana.org

APPLICATION FORM FOR MASTERS/ RESEARCH

PROGRAMMES
Academic Session 2012-13
Application Form No.
(For Office Use Only

Paste Here One

Recent Passport
Size Color
Photograph
(DO NOT
STAPLE)

Programme Applied for:

Programme
Subject
Fee Details
Name of Bank

D.D. No. &Date

Amount

NOTES:
1. Read the information available on website carefully before filling application form.
2. Please fill all the columns legibly in block letters. The candidate shall be responsible for all entries.
No documents (Copies of certificates, mark sheets etc.) is required to be attached. Before filling
application form, the candidates are advised to ensure their eligibility for the programme applied for
in accordance with the eligibility conditions for the various programmes available on website. It will
be the sole responsibility of the candidate to make sure that he/she fulfils all the conditions
prescribed for admission. The decision of the University shall be final.
2. Incomplete or unsigned applications shall be rejected summarily.
Name (in CAPITAL letters)

..

Fathers Name

...

Mothers Name

....

Sex

Date of Birth

...

Address for Correspondence ..............................................

.............................................................................................
Phone Cell . E-Mail
Category (SC / ST / OBC / PH / Others) .

Academic Qualifications
Examination
Passed

Board/
University

Year of
Passing

Max
Marks

Marks
Obtained

% of
Marks &
Division

Subjects Studied
and Passed

Matric
Inter/ SSC/ 10+2
Graduation
..........................
Post-Graduation
..........................
Any Other
Examination
a) Give details of publications & research work carried out, if any

..

b) Have you qualified in the UGC National level test for JRF/NET/SLET? Write, Yes or No.
If yes, give the following details:
Name of the Exam.
Roll No. Subject: Year & Date of
Examination
If holding the Fellowship, the date from which it is held: Date Month..
Year.
c) Do you possess M.Phil. degree?
(for those applying for Ph.D. admission)
Write, Yes or No
State if there was any gap in your studies. Give period, reasons etc.:
.........
.........
Present or previous employment, if any
Organization & Address
Position Held

Duration/ Period

Nature of Duties

Any other relevant information:

.....
....
.....................
....................
I hereby declare that the information given above is true. I hereby undertake to pay the fees and
other charges as prescribed from time to and will abide with the rules and regulations in force as
amended by the University from time to time.
Place:

Signature of Candidate

Date:
PRESENT RESIDENTIAL ADDRESS

MAILING ADDRESS

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PIN
Tel No. / Cell .
Email: .

..

...
PIN .
Tel No. / Cell
Email:

UNDERTAKING BY THE APPLICANT

I solemnly affirm that the information furnished above is true and correct in all respects. I have not
concealed any information. In case any information in this application is found to be false or
incorrect at any time (during or after completion of the course), this shall entail automatic
cancellation of my admission, if granted, cancellation of the degree if awarded, besides rendering
me liable to such action as the University may deem fit. In the event of any medical or other
emergency, my parent/s or Guardian may be contacted at the address given below:

Place:
Date:

Signature of the Candidate

Name and address of local guardian (if any)

...
(For M.Phil/Ph.D. Students only)
Mention areas of research interests in order of preference:
1) .
2) ...
3) .

PROPOSED AREA OF RESEARCH (Not exceeding 300 words for M.Phil and not exceeding 500 words
for Ph.D.). Attach separate sheet if necessary. IT IS NECESSARY AS IT WILL FORM BASIS OF
INTERVIEW).
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CENTRAL UNIVERSITY OF HARYANA

(Established vide Act 25 (2009) of Parliament)

VILLAGES (JANT-PALI), MAHENDERGARH, HARYANA

Temporary Camp Office: Govt. B.Ed. College Building, Narnaul (Distt. Mahendergarh) Haryana-123001

TEL: 01282-255002, 255003;

Website: www.cuharyana.org

HALL TICKET FOR ENTRANCE EXAMINATION/ INTERVIEW

Number
(For Office Use Only)

[TO BE SUBMITTED WITH APPLICATION FORM OFFICE COPY]

Paste Here One

Recent Passport Size
Color Photograph
(DO NOT STAPLE)

Signature of Issuing Authority .

Seal

(To Be Filled in by Candidate)

Programme
Subject

Name.
(IN CAPITAL letters)
Fathers Name.
Mothers Name.
Sex Date of Birth ......
Address for Correspondence
................................................................................................................
Phone Cell . E-Mail
Proposed Area of Research
(In case of Research Programmes only)

Place:
Date:

Signature of the Candidate

CENTRAL UNIVERSITY OF HARYANA

(Established vide Act 25 (2009) of Parliament)

VILLAGES (JANT-PALI), MAHENDERGARH, HARYANA

Temporary Camp Office: Govt. B.Ed. College Building, Narnaul (Distt. Mahendergarh) Haryana-123001

TEL: 01282-255002, 255003;

Website: www.cuharyana.org

HALL TICKET FOR ENTRANCE EXAMINATION/ INTERVIEW

Number
(For Office Use Only)

[TO BE SUBMITTED WITH APPLICATION FORM CANDIDATESCOPY]

Paste Here One

Recent Passport Size
Color Photograph
(DO NOT STAPLE)

Signature of Issuing Authority .

Seal

(To Be Filled in by Candidate)

Programme
Subject

Name.
(IN CAPITAL letters)
Fathers Name.
Mothers Name.
Sex Date of Birth ......
Address for Correspondence
................................................................................................................
Phone Cell . E-Mail
Proposed Area of Research
(In case of Research Programmes only)

Place:
Date:

Signature of the Candidate

RESERVATION POLICY
The University is governed by the reservation policies of the Government of India as issued and
amended from time to time. The reservation policy followed by the university for the current
academic year is as follows:
1.
2.
3.

5% relaxation in marks to SC/ST candidates for deciding minimum eligibility conditions.

10% relaxation for Kashmiri migrants for deciding minimum eligibility conditions.
Increase in intake capacity up to 5 % (KM)

OTHER BACKWARD CLASS (OBC)

SCHEDULED CASTES (SC)
SCHEDULED TRIBES (ST)
PHYSICALLY HANDICAPPED (PH)

27%
15%
7.5%
3%

THE UNIVERSITY SHALL FOLLOW THE RESERVATION POLICY OF GOVERNMENT OF INDIA AND
INSTRUCTIONS ISSUED FROM TIME TO TIME IN TOTO. CANDIDATESSHOULD SUBMIT RELEVANT
CERTIFICATES IN ORIGINAL AT THE TIME OFADMISSION FOR AVAILING THE ABOVE RESERVATION.