tokgjyky usg: fo'ofo ky; JAWAHARLAL NEHRU UNIVERSITY

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1 Cost of Application Form: Rs. 200/- Last Date for Submission: 29th January, 2016 (For Office Use Only) Direct Ph.D. (on the basis of viva voce only) Part A tokgjyky usg: fo'ofo ky; JAWAHARLAL NEHRU UNIVERSITY Application for Direct admission to Ph. D. Programme Academic Year (Monsoon Semester) 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, on false information furnished by the candidate, will be cancelled ipso facto. ;gk viuk ikliksvz vkdkj dk lr;kfir QksVks fpidk,a Paste (Not Staple ) Your attested Passport size Photograph here 1. iwjk uke ¼lkQ v{kjksa esa½ Name in full (IN BLOCK LETTERS): 2. (i) firk dk uke Father's Name: (ii) ekrk dk uke Mother's Name: 3. (i) i=kpkj gsrq irk ¼Li"V v{kjksa esa½ Address for correspondence (in block letters) fiu dksm Pin Code Telephone No. (with STD code) Mobile No. , if any Fax No., if any (ii).lfkk;h irk Permanent Address fiu dksm Pin Code 4. fo'ks"k oxksza ds Nk= Students of Special Categories: (a) (b) ;fn vki bu fo'ks"k oxksza esa ls fdlh ls Hkh lecaf/kr gsa rks vuq0 t0 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.) ;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) 5. 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.) 6. 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 dsunz dksm v/;;u {ks= dksm School Code Centre Code Field of Study Code 1/A

2 7. Male/Female/Other Gender 8. jk"vªh;rk Nationality: 9. vf/kokl dk jkt; State of Domicile 10. 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) 11. 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 tkjhdrkz csad Bank Draft Number Date Amount 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. Mobile No. Fax No., if any 2/A

3 (For Office Use Only) Direct Ph.D. (on the basis of viva voce only) Part B tokgjyky usg: fo'ofo ky; JAWAHARLAL NEHRU UNIVERSITY Application for Direct admission to Ph. D. Programme Academic Year (Monsoon Semester) 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, on false information furnished by the candidate, will be cancelled ipso facto. ;gk viuk ikliksvz vkdkj dk lr;kfir QksVks fpidk,a Paste (Not Staple ) Your attested Passport size Photograph here 1. iwjk uke ¼lkQ v{kjksa esa½ Name in full (IN BLOCK LETTERS): 2. (i) firk dk uke Father's Name: (ii) ekrk dk uke Mother's Name: 3. (i) i=kpkj gsrq irk ¼Li"V v{kjksa esa½ Address for correspondence (in block letters) fiu dksm Pin Code Telephone No. (with STD code) Mobile No. , if any Fax No., if any (ii).lfkk;h irk Permanent Address fiu dksm Pin Code 4. tue frffk Date of Birth 5. 1 vdrwcj 2016 dks vk;q Age as on 1st October 2016 o"kz Year ekg Months fnu Days 6. 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 dsunz dksm v/;;u {ks= dksm School Code Centre Code Field of Study Code 7. Male/Female/Other Gender 8. jk"vªh;rk Nationality: 9. vf/kokl dk jkt; State of Domicile 1/B

4 10. '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 o"kz Js.kh vad fo ky; fy, x;s fo"k; Examination Yr. of Class/ lhthih, LkaLFkku dk uke dk uke iz'ui=k 'kh?kz fu"ks/k Passed passing Division % age of Name of Board/ 'kh"kzd ;fn dksbz gks marks/ Name of the School/ University Subject/papers CGPA $ College/Institution offered and topic of dissertation,if any gkbz mpprj ek/;fed High School /Higher Sec. lhfu;j Ldwy lfvzfqdsv (10+2) bavjehfm,v Sr. School Certificate (10+2) Intermediate Bachelor's Degree Master's Degree M.Phil./M.Tech./MPH Any other examination $ Cumulative Grade Point Average 11(a) Please indicate total duration of M.Phil./M.Tech./M.P.H. programme(inclusive of dissertation) Years. 11(b) Title of M.Phil./M.Tech./M.P.H. Dissertation **12. D;k vkidh dksbz izdkf'kr gqbz gs\ Have you published any articles /books? gk Yes ugha No ;fn gk ] rks fooj.k nsa if yes, give details: dk 'kh"kzd izdkf'kr if=dk izdk'ku dh frffk Title of Articles /Books Publisher/ Journal Date of Publication 2/B

5 **13. 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 vof/k iz;kstd izkf/kdkjh dk uke o irk Title of the Project Duration Name of the sponsoring **14. (A) orzeku,oa iwoz lsok ¼vius orzeku in ls 'kq: djrs gq,½ Present and previous employment (starting with present post) : lalfkk,oa irk in vof/k dk;z dh izd`fr Organisation & Address Position held Period Nature of Duties **;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 lalfkk,oa irk in ls rd Teaching Organisation Position From To & Address held (a)lukrd Lrj d{kk,a Under-graduate classes (b)lukrdksùkkj d{kk,a Post-graduate Classes 2. 'kks/k Research: 3. vu; Others: 4. dqy vof/k o"kz eghus Total Period: years Months Note:,d gh le; ds nksgjs vuqhko dks nks ckj u fxusaa Please avoid overlapping of the period of experience. 15. D;k vkius fons'k ;k=k dh gs\ Have you undertaken foreign travel? gk Yes ugha No ;fn gk rks fooj.k nsaa if yes, give details: authority with address ** ;fn vko';d gks rks vyx ls fooj.k layxu djsa A Attach separate sheet, if necessary. ns'k dk uke vof/k ;k=k dk mís'; Country/ Countries visited Duration 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 2. ;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? gk Yes ugha No 3/B

6 3. 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) Registration No. (b) Centre (c) School (d) Whether selected for viva-voce gk Yes ugha No 4. Have you been an applicant for any course in JNU? (a) in the current year or (b) previous year(s) If so, programmes applied for year of application and outcome i.e. finally selected/not selected 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. 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 have been declared and copy attached with the application form. (I) (ii) (iii) (iv) (v) (vi) (vii) (viii) (ix) DOCUMENTS REQUIRED TO BE SUBMITTED ALONGWITH THE APPLICATION FORM 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 : Rs.1850/- (Rs.200/- for cost of application form + Rs. 1650/- 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. 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. 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. Two testimonials from persons, one of whom should preferably be a former teacher of the applicant. Copies of publication(s) of the candidate, if any, which he /she considers to be the most representative of his/her intellectual ability. Copies of Research Experience certificate from the competent authority. 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. A research proposal of about1000 words is to be submitted by the candidate alongwith Application Form. 4/B

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