Application Form

Ph.D. Entrance Exam 2023

Registration Closed
Research Entrance Exam Date 12th March 2023

Registration Closed

Instructions

All fields marked with * are mandatory to be filled.
Please deposit payment of 2500/- in the below mentioned account and send the screenshot of payment alongwith the details such as Full Name, Father's Name, Date Of Birth and Contact Details on WhatsApp No.88242-36973
Bank Name : AU Small Finance Bank A/C Holder Name : Shri Khushal Das University IFSC Code : AUBL0002283 A/C No. : 2121228336977889
Please keep the following self-attested scanned documents ready before filling the application form:

Mark sheet of Post Graduation
Aadhaar Card No./Aadhar Enrollment No.
Passport sized (dimension 200 x 230 pixels preferred) photograph and signature (dimension 140 x 60 pixels preferred)

1. Please scan and keep ready the following documents first before filling the application form:
Mark sheet of Post Graduation	Passport sized photograph (dimension 200 x 230 pixels preferred)
Signature (dimension 140 x 60 pixels preferred)

Select Program

* Require

Subject applying for

* Require

Select Mode of Exam

* Require

Exam Centre

Personal Details

Title*

First Name*

Middle Name

Last Name

Mobile No.*

Alternate Mobile No.

WhatsApp No.*

Email ID*

Age*

Gender*

Alternate Email ID

Are You Differently Abled ?*

Marital Status*

Category*

Aadhaar Number *

PAN Number

Father's Name*

Father's Mobile No.

Father's Email ID

Father's Occupation

Mother's Name*

Mother's Mobile No.

Mother's Email ID

Mother's Occupation

Family Income

Guardian Name *

Guardian Mobile No.*

Guardian Email Id

Guardian Occupation*

Relationship With Applicant*

Family Income *

Address

Country*

State / Union Territory*

District *

Pincode *

Address Line 1*

Address Line 2

Is Permanent Address Same As Address For Communication?* Yes No

Country*

State / Union Territory*

District *

Pincode *

Address Line 1*

Address Line 2

Academics and Other Activities

Candidates's Name as per qualifying examination marksheet *

10th Details

	Institute *	Board *	Year of Passing *	Marking Scheme	Percentage/CGPA	Roll No	Medium of Education	Upload Document: 10th Marksheet *
x

12th Details

	Institute *	Board *	Year of Passing *	Marking Scheme	Percentage/CGPA	Roll No	Medium of Education	Upload Document: 12th Marksheet
x

Graduation Details

	Institute *	University *	Year of Passing *	Marking Scheme	Percentage/CGPA	Roll No	Medium of Education	Upload Document: Graduation Marksheet
x

Post Graduation Details

	Institute *	University *	Year of Passing *	Marking Scheme	Percentage/CGPA	Roll No	Medium of Education	Upload Document: Post Graduation Marksheet *
x

Have you passed M. Phil ?* Yes No

M.Phil Details

	University *	Board *	Year of Passing *	Subject	Percentage	Registration No	Medium of Education	Upload Document: M.Phil Certificate
x

Have you passed NET/SLET/JRF/Any Other ?* Yes No

	Upload Document:
x

Step 5: Declaration

I hereby declare that the details furnished above are true and cor rect to the best of my knowledge and belief and I undertake to inform you of any changes therein, immediately. In case any of the above information is found to be false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it. I hereby authorize sharing of the information furnished on this form.

This registration/admission is provisional and is subject to physical verification of documents as per university rules.

University reserves are right to cancel this registration/admission on its behalf with all disclosures.

Applicant Name *

Upload passport size photograph *

Upload scanned copy of applicant signature *

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