Course Type  * :  
Course Applied for  * :  
Year/Semester  * :  
Candidate Type  * :  
Seeking Admission in Ph.D. Subject  * :  
Proposed Title of Ph.D  * :  
Candidate Information (Enter Name in Block Letter, Do not write Shri / Smt. / Km/Ms)
Candidate's Name  *    
Mother's Name *        
Father's Name *        
Gender *               
Date of Birth (High School/Equivalent Certificate) *        
Mobile No. *  
Email ID *        
Aadhar No. *         
Nationality *        
Religion *             
Category *        
           
Present Address          
House No        
Village/Town/Locality        
State        
City        
Pincode        
           
Permanent Address        
House No        
Village/Town/Locality        
State        
City        
Pincode        
Father Occupation/Designation        
Father Mobile Number        
           
Ward of Freedom Fighters/Ex. Defence Person or Physically Challenged (Enclose copy of certificate)      
Blood Group                                                    
Registration Fee Payment Mode  *               
       
Academic Qualification Details      
ExaminationBoard/UniversityYearRoll No.Marks Obt.Max MarksPercentageCGPA
High School
Intermediate
Graduation
Post Graduation
Other/M.Phil.
NET/SLET/JRF

Candidate Photograph Width:3.5cm Height:3.5cm Candidate Signature:W:3.5cm H:1.5cm
     
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