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Annexure-I

JAMIA MILLIA ISLAMIA Jamia Nagar, new Delhi-110025

APPLICATION FOR ADMISSION TO THE DOCTOR OF PHILOSPHY (Ph.D.) PROGRAMME

The Chairman, Board of Studies/ Committee of Studies, Department/ Centre of ……………………… Faculty of ……………………………….…. Jamia Millia Islamia, New Delhi – 110025 Sir,

1. I am applying for admission as research scholar to the Ph. D. programme in ……...............……….. under the Faculty of/ Centre for …………………………………………. and submitting the following particulars in support of my application along with a crossed Demand Draft of Rs. 1000/- vide no. ………………………. dated …………………, issued by (Bank) …………………….. .

2. I would also like to be considered for admission as research scholar to the Ph.D. programme in ………………………….. Department/Centre/Faculty, as my subject of Post graduation is being considered as an allied subject in the Department/Centre/Faculty as mentioned below in Note A of this application form.

Yours faithfully,

Date……………………… (Signature of the Candidate)

Name: ……………………….

(PARTICULARS TO BE FILLED BY THE CANDIDATE)

Category (see Note (B) for category code): ……………………………………………………....................

Name of the Candidate …………………………………………………………………………………..

Father’s Name …….……………………………………………………………………………………...

Mother’s Name …………………………………………………………………………..........................

Name of Spouse (if married) ……..………………………………………………….…………………............

Date of Birth (as given in the Matriculations/ Secondary School Certificate) ……….…………………..

Nationality……………………………….. Jamia Enrolment No. (if any) …….………………………….

Permanent Address............................................................................................................................ …

……..…………………………………………………………………………………………………….............

………………………………………………………………………………………………………......................

Local Address (with proof of residence)……. …….………………………………………………………….

……….. ……..……………………………………………………………………………………………………...

……………………………………………………………………………………………………………. ………..

Telephone with STD code: ………………………………... Mobile: ……………………………… ……

E-Mail: ……………………………………………………………………………………………………………..

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DETAILS OF PREVIOUS EXAMINATIONS

Exam Passed Name of the University

Year of Passing

Division & Percentage

Subjects

UG Course

PG Course

M.Phil.

Any Other

Proposed Topic of Research ……………………………………………………………………………….

Details of Research experience, if any (Attach separate sheet, if necessary) …….……………………...

Languages, which the candidate knows …….……………………………………………………………

If employed, write the name of the institution and the position held ………………..…………………...

……………………………………………………………………………………………………………………… I declare that the information provided above are true in all respect. Dated …………………… (Signature of the Candidate)

(RECOMMENDATION OF THE BOARD OF STUDIES/ COMMITTEE OF STUDIES)

The Board of studies/ Committee of Studies held on ………………recommended Shri/ Smt./ Km. ………………………………………………………………For admission to the Ph. D. Course in……………………on the topic ……………..………………………………………………………………….

………. ……...……………………………………………………………………………………………………...

under the supervision of …….. …….……………………………………………………………………………

Chairman Board of Studies/ Committee of Studies Department/ Centre/ Faculty …...………………….. (APPROVAL OF THE DEAN OF THE FACULTY/ DIRECTOR OF THE CENTRE)

Dated………………… Signature of the Dean/ Director with Seal

Note: (A) Allied Subjects: To ensure the correct choice of the allied subjects refer to “Ph.D. Admission

2013-14” at JMI website (www.jmi.ac.in) under Ph.D. admissions – no. of vacancies. (B) If a candidate is applying for admission to Ph.D. programme in two Departments/Centres/

Faculty, he/she will be required to submit separate “Research Proposal” in the respective Departments/Centres/Faculty, by the due date (as per the schedule).

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(C) The following documents will have to be submitted at the time of submitting the application form.

1. Attested copies of all Mark Sheets and Degrees of Graduation and Post Graduation Examinations. 2. Proof of the date of birth. 3. Proof of claimed reserved category. 4. An attested copy of M.Phil. Marks Sheet/ Degree (in case of exemption from the Entrance Test is required). 5. An attested copy of UGC NET/SLET or an equivalent examination (in case of exemption from the Entrance

Test is required). 6. An attested copy of valid GATE Score Card.

(D) Category Code:

G: General M: Muslim MW: Muslim Women MO: Muslim OBC MT: Muslim Scheduled Tribe PD: Persons with Disability

If at any stage it is found that the applicant has provided false/incorrect information, his/her application is liable to be rejected and admission (if granted) will be cancelled.

JAMIA MILLIA ISLAMIA

Jamia Nagar, New Delhi-110025

Admit Card for Entrance Test 2013-2014

Course applied for: ................................................. Dept./Faculty .............................

Name (In Block Letters):......................................................................................................

Father’s Name:.............................................................................................................

Mother’s Name:.............................................................................................................

Address:........................................................................................................................

....................................... .......................................

Signature of Applicant Signature of Invigilator

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R C

EN

TR

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JAMIA MILLIA ISLAMIA

Jamia Nagar, New Delhi-110025

Admit Card for Entrance Test 2013-2014

FO

R C

AN

DID

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Form No.

Roll No.

(To be filled by the office)

Form No.

Course applied for:................................................. Dept./Faculty .................................

Name (In Block Letters) : ..........................................................................................................

Father’s Name:..................................................................................................................

Mother’s Name:.................................................................................................................

Address:............................................................................................................................

....................................... .......................................

Signature of Applicant Signature of Invigilator

Note: Contact the Concerned Dept /Faculty for venue of Entrance Test.

Acknowledgement Slip

Received an Application Form from (Candidate’s Name) ............................................................ for admission

to ................................................................................................course.

...........................................................

Date................................. Signature of receiving official with Stamp

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Affix your recent

self attested coloured

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It should be pasted with gum

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Form No.