Direct Ph.D.
Cost of Application Form: Rs. 200/Last Date for Submission: 30th January, 2015
(on the basis of viva voce only)
(For Office Use Only) Application Form No.___________
tokgjyky usg: fo'ofo|ky; JAWAHARLAL NEHRU UNIVERSITY Application for Direct admission to Ph. D. Programme Academic Year 2015-16
fo'ks"k fVIIk.kh % v/kwjs Hkjs gq;s vkosnu&i= vLohd`r dj fn, tk,axs vkSj ;fn mEehnokj }kjk nh xbZ xyr lwpuk ds vk/kkj ij izos'k fn;k x;k gS rks og jn~n dj fn;k tk,xkA Important Note : Incomplete applications will be summarily rejected and admission, if granted,
;gk¡ viuk ikliksVZ vkdkj dk lR;kfir Qks Vks fpidk,a Paste (Not Staple ) Your attested Passport size Photograph here
on false information furnished by the candidate, will be cancelled ipso facto.
1.
iwjk uke ¼lkQ v{kjksa esa½ Name in full (IN BLOCK LETTERS): ________________________________________________________
2.
(i) (ii)
3.
(i)
4.
tUe frfFk Date of Birth ____________________________________________________________________________________
5.
1 vDrwcj 2015 dks vk;q Age as on 1st October 2015 __________o"kZ Year__________ekg Months_______ fnu Days________
6.
fo'ks"k oxksZa ds Nk= Students of Special Categories:
7.
firk dk uke Father's Name: ___________________________________________________________________________ ekrk dk uke Mother's Name: ___________________________________________________________________________
i=kpkj gsrq irk ¼Li"V v{kjksa es½a Address for correspondence (in block letters) _________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ _______________________________________________________________fiu dksM Pin Code________________ Telephone No. (with STD code)_______________________________ Mobile No.____________________________ E-mail, if any__________________________________________ Fax No., if any____________________________ (ii).LFkk;h irk Permanent Address __________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________ fiu dksM Pin Code ________________
(a)
;fn vki bu fo'ks"k oxksZa esa ls fdlh ls Hkh lEcaf/kr gSa rks vuq0 tk0@vuq0 t0 tk0@v-fi-otks Hkh ykxw gks] fy[ksa ¼vius bl nkos ds leZFku esa izek.k i=k layXu djsa½ If you belong to any of special categories, please write SC/ ST/OBC (OBC only non Creamy Layer), as applicable (attach a copy of certificate in support of your claim in this regard.)
(b)
;fn vki 'kkfjfjd :i ls fodykax gSa rks 'kk0 fo0 fy[ksa ¼vius bl nkos ds leFkZu esa fpfdRlk izek.k&i=k layXu djsa½ If you are Physically Challenged (Handicapped) (minimum 40% disability) please write PH (attach a copy of medical certificate in support of your claim)
v/;;u&{ks= rFkk ml dsUnz dk uke ftlesa ih-,p-Mh- essa lh/ks izos'k ysuk gSA Field of Study and the name of Centre/School to which direct admission to Ph. D. Programme is sought. laLFkku dksM School Code
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dsUnz dksM Centre Code
v/;;u {ks= dksM Field of Study Code
8.
Male/Female/Third Gender ______________________________________________________________________________
9.
jk"Vªh;rk Nationality: _____________________________________________________________________________________
10. vf/kokl dk jkT; State of Domicile ___________________________________________________________________________ 11. If you belong to Below Poverty Line, please write BPL , as applicable (attach a copy of certificate in support of your claim in this regard.)
12. 'kS{kf.kd O;kSjk ¼dssoy mUgha fo"k;ksa ds vadks dks fxusa] ftldh x.kuk Js.kh nsus gsrq dh xbZ gSA½ Academic Record (Take into account only marks in the subjects which are counted for awarding class /division.) mÙkh.kZ Examination Passed
o"kZ Js .kh Yr. of Class/ passing Division
va d fo|ky;@fo'ofo|ky;@ lhthih, LkaLFkku dk uke % age of marks/ Name of the School/ CGPA $ College/Institution
cksMZ@fo'ofo|ky; dk uke Name of Board/ University
fy, x;s fo"k; iz'ui=k 'kh?kz fu"ks/k 'kh"kZd ;fn dksbZ gks Subject/papers offered and topic of dissertation,if any
gkbZ Ldwy@ mPprj ek/;fed High School /Higher Sec. lhfu;j Ldwy lfVZfQdsV (10+2) baVjehfM,V Sr. School Certificate (10+2) Intermediate Bachelor's Degree Please Specify ______ ___________________ Master's Degree Please Specify ______ ___________________ M.Phil./M.Tech./MPH Please Specify ______ ___________________ Any other examination Please Specify ______ ___________________ $ Cumulative Grade Point Average 12(a) Please indicate total duration of M.Phil./M.Tech./M.P.H. programme(inclusive of dissertation)___________ Years. 12(b) Title of M.Phil./M.Tech./M.P.H. Dissertation__________________________________________________________ __________________________________________________________________________________________ **13. D;k vkidh dksbZ jpuk@iqLrd izdkf'kr gqbZ gS\ Have you published any articles /books?
gk¡ Yes
ugha No
;fn gk¡] rks fooj.k nsa if yes, give details: ys[k@iqLrd dk 'kh"kZd Title of Articles /Books
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izdkf'kr if=dk
izdk'ku dh frfFk
Publisher/ Journal
Date of Publication
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**14. D;k vkius dksbZ 'kks/k ifj;kstuk 'kq: dh gS\ Have you undertaken any Research Project?
gk¡ Yes ugha No
;fn gk¡, rks fooj.k nsa if yes, give Details: ifj;kstuk dk 'kh"kZd Title of the Project
vof/k
iz;kstd izkf/kdkjh dk uke o irk
Duration
Name of the sponsoring authority with address
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** ;fn vko';d gks rks vyx ls fooj.k layXu djsa A Attach separate sheet, if necessary. **15. (A) orZeku ,oa iwoZ lsok ¼vius orZeku in ls 'kq: djrs gq,½ Present and previous employment (starting with present post) : laLFkk ,oa irk Organisation & Address
in Position held
vof/k Period
dk;Z dh izd`fr Nature of Duties
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**;fn vko';d gks rks vyx ls fooj.k layXu djsaA Attach separate sheet, if necessary (B) vuqHko ¼gky gh dh lsok ls 'kq: djrs gq,½ Experience (starting with the most recent job.) 1. v/;;u Teaching
laLFkk ,oa irk Organisation & Address
in Position held
ls From
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2. 'kks/k Research:
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3. vU; Others:
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(a) Lukrd Lrj d{kk,a Under-graduate classes (b) LukrdksÙkkj d{kk,a Post-graduate Classes
4. dqy vof/k Total Period:
o"kZ
eghus
years_________________
Months_________________
rd To
Note: ,d gh le; ds nksgjs vuqHko dks nks ckj u fxusaA Please avoid overlapping of the period of experience. 16.
D;k vkius fons'k ;k=k dh gS\ Have you undertaken foreign travel? ;fn gk¡ rks fooj.k nsaA if yes, give details: ns'k dk uke Country/ Countries visited
______________ ______________ 17.
1. 2.
vof/k Duration
________________ ________________
gk¡ Yes ugha No
;k=k dk mís'; Purpose of visit
________________ ________________
D;k vkius blls iwoZ ts-,u- ;w- esa vkosnu i= fn;k gS\ Have you applied for admission in J.N.U. earlier? gk¡ Yes ugha No ;fn gk¡ rks d`i;k iw.kZ fooj.k nhft, If Yes, Please give details (a) 'kSf{kd o"kZ ,oa v/;;u ikB~;Øe ftlds fy, vkosnu fd;k x;k A Academic year and programme of study for which applied: ______________________________________________________________________________________________________ (b) izos'k gsrq p;u gqvk ;k ugha Whether selected for admission?
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gk¡ Yes ugha No
3. 4.
Have you applied for admission in JNU this year for Pre-Ph.D./M.Phil./M.Tech./MPH/Ph.D. through Entrance Exam.
gk¡Yes ugha No
;fn gk¡ rks d`i;k iw.kZ fooj.k nhft, If Yes, Please give details v/;;u ikB~;Øe ftlds fy, vkosnu fd;k x;k A Programmes of study for which applied: Field of Study________________ (a) Centre:_________________________________________School___________________________________________ (b) Whether selected for viva-voce gk¡Yes ugha No
5. Have you been an applicant for any course in JNU? (a) in the current year or (b) previous year(s)__________________
18.
19.
If so, programmes applied for______________________________ year of application_____________________ and outcome i.e. finally selected/not selected________________________________ Family Income: Please specify Category Code: Less than Rs.50,000 per year (Code-1), Between Rs.50,000 to Rs.1,00,000 (Code-2), Between Rs.1,00,000 to Rs.2,00,000 (Code-3), Above Rs.2,00,000 (Code-4) vkosnu i= ds lkFk layXu fd, tkus okys cSad Mªk¶V dk fooj.k Details of Bank Draft enclosed: cSad Mªk¶V la[;k fnukad jkf'k Bank Draft Number Date Amount
tkjhdrkZ cSad Issuing Bank
Declaration by the Applicant I declare that entries made by me in this form and the documents submitted in support of the information furnished by me in the Application Form are true in all respects and in case any entry or information or document is found to be false, this shall entail automatic cancellation of my admission besides rendering me liable to such action as the University may deem proper. If at any stage it is found that I do not fulfil the minimum prescribed eligibility criteria, my admission, if granted, shall stand cancelled and I shall have no right to admission whatsoever. I note that my admission to the University and my continuance on its rolls are subject to the provisions of the University Statutes, Ordinances and other Rules, Regulations and Instructions which may be issued from time to time. I shall abide by the rules of discipline and proper conduct which may be framed in this regard.
fnukad Date:________________________ ( vkosnd ds gLrk{kj SIGNATURE OF THE APPLICANT) LFkku Place: ________________________ Telephone No. __________________________________ E-mail__________________________________________ Mobile No._____________________________________ Fax No., if any _________________________________ Please note that the applications of the candidates whose M.Phil/M.Tech./Pre-Ph.D./MPH results are not available will not be considered under any circumstances. Hence, the applications of only those candidates can be considered whose results are indicated/available in the application form.
DOCUMENTS REQUIRED TO BE SUBMITTED ALONGWITH THE APPLICATION FORM (I)
Candidates are required to enclose Demand Draft drawn in faour of JAWAHARLAL NEHRU UNIVERSITY payable at NEW DELHI as per the following rates towards cost of application form and processing fees with the Application Form: For General and OBC Category For candidates belonging to SC/ST and Physically Challenged (PH) Category For candidates belonging to BPL Category
: Rs.420/- (Rs.200/- for cost of application form + Rs. 220/- for processing fee) : Rs.310/- (Rs.200/- for cost of application form + Rs. 110/- for processing fee) : Rs.110/- for processing fee
For Foreign National candidates
(ii)
: Rs.1750/- (Rs.200/- for cost of application form + Rs. 1550/- for processing fee) Two attested copies of each of the certificates and mark-sheets of the examinations stated to have been passed by the candidate including certificate showing the age of the candidate.
(iii)
The candidates who have passed the qualifying examination from a Foreign University should submit all the relevant information/documents which may justify the equivalence of their qualifications. In case the certificates/mark-sheets are in a language other than English, the English version of such documents duly attested by a Gazetted Officer should also be enclosed.
(iv)
A complete list of papers /subjects taken by the candidate at Bachelor's and Master's level examinations stated to have been passed by him/her.
(v)
Two testimonials from persons, one of whom should preferably be a former teacher of the applicant.
(vi)
Copies of publication(s) of the candidate, if any, which he /she considers to be the most representative of his/her intellectual ability.
(vii)
A brief note (one copy) stating the candidate's area of specialised interest of research, if any, and his future professional goals, and such other additional information that may help his/her selection to the programme of study.
(viii)
A research proposal of about1000 words is to be submitted by the candidate alongwith Application Form.
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