PHD Full Time Application 2013

FORM-R1
ANDHRA UNIVERSITY
DIRECTORATE OF ADMISSIONS
ORIGINAL
Registration No.
APPLICATION FORM FOR FULL-TIME M.Phil./Ph.D. RESEARCH ADMISSION

Last date for receipt of filled-in applications without fine: 20-06-2013 (5 p.m.);
With late fee of Rs. 1,000/- , 30-06-2013 (5 p.m.)
Note: Admission into M.Phil./Ph.D. degree shall be made in accordance with guidelines specified in the
Resarch admission information Brochure. Strike off whichever is not applicable and put a
mark wherever necessary. Each application should be accompanied by a D.D. of Rs. 800/(Rs.500/- for SC & ST) drawn in favour of Director, Directorate of Admissions, Andhra
University, Visakhapatnam on any Nationalised Bank, payable at Visakhapatnam.
Affix attested
recent
Passport size
photo
1. Particulars of Registration Fee:

Amount: Rs. ............D.D.No. ......................... Date: .................
Name of the Bank: ...................
2. Department Code
& Name
3. Research Programme for which the candidate wants to be considered
M.Phil
Ph.D.
Ph.D. Interdisciplininary
4. Name of the Applicant (in Capital Letters):

SURNAME
NAME
5. Name of the Father / Mother :

(Guardian, if parents are not alive)
DATE
6. Sex: Male
8. Residential status:
9. Reservation Category:
Non-local
Local
SC
MONTH
YEAR
7.Date of Birth:
Female
ST
BC-A
BC-B
Other State
BC-C
BC-D
BC-E
PH
10. Particulars of Qualifying Examination (Attested Xerox Copies of the Marks statements & PC must be
enclosed. Otherwise the application will be Rejected)*
Qualifying
P.G./M.Phil.
Degree
Subject studied /
Specialization
Percentage
of Marks /
CGPA
University
Year of
Passing
11. Whether qualified in NET/APSET :YES / NO

INSPIRE FELLOWSHIP If Yes, indicate the test and
score:
12. Permanent Address:
13. Address for communication:
..............................................................................
....................................................................................
..............................................................................
....................................................................................
..............................................................................
....................................................................................
..............................................................................
....................................................................................
PIN code:.......................Ph.No..................................
PIN code:.......................Ph.No.......................................
Email : .....................................................................
Mobile No : ...................................................................
* T ho se w ho a p p e a r e d f o r fi na l y e a r / Se m e st e r e x a m in a t io ins h a v e to inc lude a ll certific ates till da te.
14. Name of the Research guide in the department

: .............................................................................................
under whose guidance the candidate would like to work.**
15. For candidates who wish to pursue inter-disciplinary research.
(a) Names of the departments in which Inter-disciplinary
research will be pursued
: 1) ......................................................................................
2) ......................................................................................
(b) Names of the guides and their departments in which
inter-disciplinary research will be pursued.
: 1) ......................................................................................
2) ......................................................................................
** This does not entail the candidate to get the allotment under the same guide.
DECLARATION BY THE CANDIDATE

I here by declare that the particulars given in items 1 to 16 above are correct. In the event of any
information being found false, I declare to forego my admission forthwith.
Date:
Signature of the candidate
FORM-R1
ANDHRA UNIVERSITY
DIRECTORATE OF ADMISSIONS
DUPLICATE
Registration No.
APPLICATION FORM FOR FULL-TIME M.Phil./Ph.D. RESEARCH ADMISSION

Last date for receipt of filled-in applications without fine: 20-06-2013 (5 p.m.);
With late fee of Rs. 1,000/- , 30-06-2013 (5 p.m.)
Note: Admission into M.Phil./Ph.D. degree shall be made in accordance with guidelines specified in the
Resarch admission information Brochure. Strike off whichever is not applicable and put a
mark wherever necessary. Each application should be accompanied by a D.D. of Rs. 800/(Rs.500/- for SC & ST) drawn in favour of Director, Directorate of Admissions, Andhra
University, Visakhapatnam on any Nationalised Bank, payable at Visakhapatnam.
Affix attested
recent
Passport size
photo
1. Particulars of Registration Fee:

Amount: Rs. ............D.D.No. ......................... Date: .................
Name of the Bank: ...................
2. Department Code
& Name
3. Research Programme for which the candidate wants to be considered
M.Phil
Ph.D.
Ph.D.Interdisciplininary
4. Name of the Applicant (in Capital Letters):

SURNAME
NAME
5. Name of the Father / Mother :

(Guardian, if parents are not alive)
DATE
6. Sex: Male
8. Residential status:
9. Reservation Category:
Non-local
Local
SC
MONTH
YEAR
7.Date of Birth:
Female
ST
BC-A
BC-B
Other State
BC-C
BC-D
BC-E
PH
10. Particulars of Qualifying Examination (Attested Xerox Copies of the Marks statements & PC must be
enclosed. Otherwise the application will be Rejected)*
Qualifying
P.G./M.Phil.
Degree
Subject studied /
Specialization
Percentage
of Marks /
CGPA
University
Year of
Passing
11. Whether qualified in NET/APSET :YES / NO

INSPIRE FELLOWSHIP If Yes, indicate the test and
score:
12. Permanent Address:
13. Address for communication:
..............................................................................
....................................................................................
..............................................................................
....................................................................................
..............................................................................
....................................................................................
..............................................................................
....................................................................................
PIN code:.......................Ph.No..................................
PIN code:.......................Ph.No.......................................
Email : .....................................................................
Mobile No : ...................................................................
* T ho se w ho a p p e a r e d f o r fi na l y e a r / Se m e st e r e x a m in a t io ins h a v e to inc lude a ll certific ates till da te.
14. Name of the Research guide in the department

: .............................................................................................
under whose guidance the candidate would like to work.**
15. For candidates who wish to pursue inter-disciplinary research.
(a) Names of the departments in which Inter-disciplinary
research will be pursued
: 1) ......................................................................................
2) ......................................................................................
(b) Names of the guides and their departments in which
inter-disciplinary research will be pursued.
: 1) ......................................................................................
2) ......................................................................................
** This does not entail the candidate to get the allotment under the same guide.
DECLARATION BY THE CANDIDATE

I here by declare that the particulars given in items 1 to 16 above are correct. In the event of any
information being found false, I declare to forego my admission forthwith.
Date:
Signature of the candidate
ADDRESS SLIPS
Name:...........................................................................
Address : ...................................................................
.......................................................................................
..........................................................PIN:.....................
Name:...........................................................................
Address : ....................................................................
.......................................................................................
..........................................................PIN:.....................
Name:...........................................................................
Address : ....................................................................
.......................................................................................
..........................................................PIN:.....................
Name:...........................................................................
Address : ....................................................................
.......................................................................................
..........................................................PIN:.....................

PHD Full Time Application 2013

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FORM-R1

APPLICATION FORM FOR FULL-TIME M.Phil./Ph.D. RESEARCH ADMISSION

1. Particulars of Registration Fee:

Name of the Bank: ...................

4. Name of the Applicant (in Capital Letters):

5. Name of the Father / Mother :

11. Whether qualified in NET/APSET :YES / NO

12. Permanent Address:

13. Address for communication:

* T ho se w ho a p p e a r e d f o r fi na l y e a r / Se m e st e r e x a m in a t io ins h a v e to inc lude a ll certific ates till da te.

14. Name of the Research guide in the department

DECLARATION BY THE CANDIDATE

Signature of the candidate

APPLICATION FORM FOR FULL-TIME M.Phil./Ph.D. RESEARCH ADMISSION

1. Particulars of Registration Fee:

Name of the Bank: ...................

4. Name of the Applicant (in Capital Letters):

5. Name of the Father / Mother :

11. Whether qualified in NET/APSET :YES / NO

12. Permanent Address:

13. Address for communication:

* T ho se w ho a p p e a r e d f o r fi na l y e a r / Se m e st e r e x a m in a t io ins h a v e to inc lude a ll certific ates till da te.

14. Name of the Research guide in the department

DECLARATION BY THE CANDIDATE

Signature of the candidate

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