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Application Form For Admission For The Degree Of Doctor Of Philosophy (Ph.d.)

Details of Online Payment of Application Fees – Rs. 3000/-

Fees Payment URL : http://seminar.atmiya.ac.in/

Date

Transaction ID

Order No.ID

Please attach copy of the Email received after the successful payment of the application fees

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Date

Place

Category under the registration is sought (Please tick appropriate) Full Time Part Time External Internal

Session applied for
January July

(a) Discipline of subject in which admission is sought
Science Commerce Management Humanities Engineering Pharmacy Interdisciplinary

(b)Specialization

Name of the Applicant

In block letters and as per certificate of secondary education

Father's/Husband's name(in block letters):

Address to which communication to be sent with pin code:

Permanent Residential Address

Correspondence Address

Personal details

Gender
Female Male Transgender

Date of Birth

Age (Years)

Nationality
Indian Foreign

Category
GEN SC ST OBC

E-mail Id

Mob. No

Landline .No

Educational Qualifications(10+2)

NAME OF EXAMINATION	YEAR	SCHOOL/COLLEGE BOARD/UNIVERSITY	PERCENT./GRADE	DIV./ CLASS	SUBJECT/ SPECIALIZATION	Enclose attested copies(Educational Qualifications)	Action

Whether cleared CSIR-NET/UGC-NET/GATE or Any Other Equivalent State Level examination?
Yes No

Professional/Teaching Experience, if any

NAME OF ORGANIZATION AND ITS ADDRESSES	DESIGNATION	DURATION (FROM - TO)	TOTAL EXP. IN YRS - MONTHS	Enclose attested copies(Professional/Teaching Experience)	Action

Research Experience, If Any

NAME OF ORGANIZATION	DESIGNATION (JRF/SRF/RA/OTHERS)	DURATION (FROM - TO)	TOTAL EXP. IN YRS - MONTHS	Enclose attested copies(Research Experience)	Action

Total Experience

TEACHING	RESEARCH	INDUSTRY	Action

Research Publications (if any)

PUBLICATION TYPE	NATIONAL/INTERNATIONAL	NUMBER	ENCLOSURE NO	Action

Award, Medal, Prize, Honours (if any):

AWARD/MEDAL/HONOURS	NATIONAL/INTERNATIONAL	REMARK	Please enclose photocopies of testimonials	Action

Have you ever been registered/completed for Ph.D./M.Phil programme to this or any other University?
Yes No

Please attach your recent Curriculum Vitae (CV)

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Please state briefly your research interests

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