TUMKUR UNIVERSITY

Vishwavidyalaya Karyalaya, B.H.Road, Tumkur-572 103

Phone No : 0816-2254546, 2255596, Fax-0816-2270719

Form-A

APPLICATION FOR Ph.D. ENTRANCE TEST

Subject …..…………….…..………………….…..…………….…..……………

1.  / Name in Full
(in capital letters)
2.  / Address for Communication
3.  / Phone / Mobile No.
4.  / Email ID (Candidates have to compulsorily mention their Email IDs)
5.  / Date of Birth (Enclose attested copy of the SSLC marks card)
6.  / Sex : Male / Female / 7. Nationality: Indian / Foreign
7.  / Category
(Enclose attested copy of the certificate) / GM/SC/ST/Cat-1/Cat-2A/Cat-2B/Cat-3A/Cat-3B/PWD
8.  / Whether passed UGC/CSIR (JRF)/SLET/K-SET /GATE or teacher fellowship? / Yes / No
If yes, specify the exam passed ……………………
(Enclose attested copy of the relevant document)
9. Details of the PG Examination Passed: (Enclose attested copies of the marks cards and passing certificate)
PG Degree and Subject / University / Year of Passing / Marks / Specialization
Maximum / Obtained / Percentage
10. / Area of Research Interest
11. / Particulars of the Fee Paid / Amount:
Bank:
DD No.:
Date:

Note: Enclose two passport size photographs along with necessary documents and DD.

Place:

Date: Signature of the Candidate


TUMKUR UNIVERSITY

B.H. Road, Tumakuru – 572103

Ph.D. Entrance Test – June 2015

ADMISSION CARD

(To be submitted along with the application)

1. Reg. No*:

* (to be allotted by the concerned Chairman)

2. Name of the Candidate: ______

3. Subject: ______

Examination Venue: Tumkur University Campus, B.H. Road, Tumakuru

Date / Time / Invigilator’s Signature
07/06/2015 / 11.00AM – 1.00PM

Note:

·  The admission card duly signed by the concerned Chairman / Director will be issued to the candidate on the date of examination from 9.00 AM onwards.

·  The candidate must carry this Admission Card to the Examination hall and should occupy his/her place in the examination hall 15 minutes before the commencement of examination.

·  The candidate shall not be allowed after 30 minutes of the commencement of the examination.

·  This Admission Card is only provisional.

Signature of the Candidate Signature of Chairman/ Director

with seal

Acknowledgement

Received the application from Sri./Smt ______in connection with Ph.D. Entrance test--2015 on ______.

Signature of Chairman/ Director

with seal