Application No.

(please do not fill)

Recent Photograph
duly signed by the
candidate

International Centre
(Application form for other than Indian Nationals only during Session 2014-15)
(FN/NRI/PIO/Children of Indian workers in Gulf & South Asian Countries (Pl. Tick & enclose details)

COURSE APPLIED FOR:

(UG/PG/Ph.D./Diploma/Certificate)
DD No.:

Date:

Processing fee* Details:

Amount:

Bank/Branch

* Processing fee: Rs. 3000.00 for SAARC Countries and Rs. 6000.00 for Non SAARC Countries (in the form of Bank Draft
drawn in favour of Registrar, Banaras Hindu University, Varanasi).The candidates willing to pay the above charges in US $
are permitted to do so in amounts equivalent to the Prescribed charges in INR.
Married / Unmarried
Personal details:
Name of Candidate (in block
letters) : Mr. / Ms.

Sex

Date of Birth:
Passport Details:

Nationality:

Name of Spouse:

Pass Port No.

Date of Issue:

Place of Issue:
Country of
residence:

Valid up to:

Family details:
Fathers Name:

Nationality:

Mothers Name:

Nationality:

Address for
correspondence
(in block letters):
PIN / ZIP

Phone

Fax

Email:

Mobile

Permanent Address
(in block letters)
PIN/ZIP

Phone

Fax

Email:

Mobile

Qualifying Examination details (Pl. refer respective Information Brochure):

Name of the Examination:

Grade/% of marks

Examining Board / University:

Language of instruction

Instructions:

Specimen Signature

1. Request for change of option and refund of Fees will not be entertained.
2. Incomplete form will not be accepted.
3. This form must be signed by the applicant.
4. This form is valid only for the year of application.
5. Application form unaccompanied with proper processing charge will not be entertained.

Educational Details:
Important: Attach certified copies of all mark sheets and certificates. English version of Documents, Certified by competent
authority be also attached in case the originals are in other than English language. Grade Conversion Formula from
the Institution is required, if marks not mentioned / awarded in Percent.
Name of Examinations
Name of the
Year of
Marks
Subjects
passed
University/ Institution
passing Obtained Max.
% age
10th Level
10 + 2 Level
Bachelor Degree
10+2+3 Level
Master Degree
10+2+3+2 Level
Any Other Degree

Other details:
Mother Tongue:
Knowledge of English:

Languages Known:
Written: Good / Fair / Poor

Whether earlier studied/admitted to BHU: Yes / No

Passed / Failed / Others (specify
details)
Whether studying in BHU:
Yes / No

Spoken: Good / Fair / Poor

Course:

Period:

Course:

Enrollment
no.
Faculty:

Result:

Present Occupation / Employment, if any:

Organization & Address

Position held

Period

Nature of duties

Salary p.m.*
*Equivalent to INR

Additional information for admission to Research:

Topic of Proposed Research:
( enclose synopsis)
Research Publications (enclose details)

No. of Publications

National

Professional Experience (enclose details)

Period:

Institution

International

Note: The candidates shall be considered for admission to the Ph.D. programme at BHU subject to fulfilling the
eligibility and other requirements and only if the degree possessed by them entitles them for enrolment/
admission to the Ph.D. Programme in their own countries.
DECLARATION
I hereby declare that:
1.
2.
3.
4.

The particulars given in this application form are true and authentic to the best of my knowledge and belief.
I have read and understood the instructions and I accept them.
I under take to return my native country after completion of the course.
In the event of my admission in the University, I will pay the required fees/charges and not ask for any
financial assistance or waiver in fee/charges during the tenure of my study as well as abide by the rules,
regulations and policies of the Government of India and Banaras Hindu University.
5. I do accept that the Banaras Hindu University shall have the right to reject my candidature at any time,
if any information is found false / fake / wrong at any stage.
Date: _____________
Place: _____________
SIGNATURE OF THE CANDIDATE

CHECK LIST for Enclosures along with Application Form (Put mark)
Checked the Eligibility Criteria for the admission to the course.
All the columns are filled in properly and correctly in this application form.
Application form has been signed on both pages and on photograph.
Grade Conversion Formula from the Institution attached (if marks not mentioned / awarded in %)
English version of Certificates / Documents, certified by competent authority are attached (in case original
Certificates / Documents are in other than English language)
Bank Draft is attached for Processing fee in favour of REGISTRAR, BANARAS HINDU UNIVERSITY
payable at VARANASI.
Photocopies of Passport attached.
Photocopies of Certificates for Proof of Age and Qualifications attached.
An Official document stating that the degree possessed by the candidate entitles him/her for enrolment/
admission to Ph.D. programme in his/her own country (for Ph.D.)
Important Dates:
Last date of receipt of completed applications

April, 30 2014

Tentative dates to report at International Centre, BHU for joining the course:
(a) Undergraduate, Postgraduate & Full-time Diploma Progrmmes

24th - 31st July, 2014

(b) Part-time Diploma and Certificate courses

11th 18th August, 2014

For Ph.D. Programme and Short Term Affiliations, applications can be made at any time of the
year. Admission to Ph.D. Programme is done in two semesters in an academic year viz. March and
Sept. (January and July for Agriculture). Accordingly, candidates are required to report in the
months of March and Sept. (January and July for Agriculture) for admission in the respective
faculty and semester.
N.B.: for eligibility requirements, equivalence of the degree/examinations to the corresponding degrees/examinations of the
Indian Universities etc., pl. refer UET/PET/SPL. COURSES/ RET Information Brochures and Ph.D.Ordinances on the
Universitys website www.bhu.ac.in
For Office use only
Course offered:

Course duration:

Department:

Faculty / Institute:

VISA type:
Additional Charges

VISA number
Amount:

Receipt No:
Course fee details

Issued at:

Rs./ $:

DD No.

Date:

Received by:

Receipt no.

Date:

Checked by:

on:
dated

Amount:

Approved by:

Send completed form to: International Centre. C/3/3, Tagore House, Banaras Hindu University, Varanasi-221005, INDIA.
email: internationalcentrebhu@gmail.com & intcent@bhu.ac.in , Phone & Fax: 91:0542 2368130,2307639 visit us at : www.bhu.ac.in

Important:
After receiving the eligibility letter and completing all necessary formalities in their countries (if any), and
procuring Student/Research Visa (for Research), from the Indian Embassy, the students are required to
report (IN PERSON)to the International Centre, Banaras Hindu University, Varanasi (India) for hassle free
admission process alongwith the following documents IN ORIGINAL (and photocopies of each):

Eligibility letter issued by the University

Marksheets/Certificate/Transcripts of their academic records/Migration/Transfer Certificate, issued by
the institution last attended
Proof of Age/ PASSPORT/ Photographs
VALID APPROPRIATE VISA (STUDENT/RESEARCH (for Research)/. Please note that the Visa/
endorsement should be specific to this effect for being acceptable to Banaras Hindu University.
The Citizenship Certificate for Nepal & Bhutan nationals only (In absence of VISA regime), duly
countersigned by the Consular Wing of the Mission of India (in the respective countries) and NO
OBJECTION LETTER from the above Mission (in case of Ph.D. Admission).
To undergo for Medical/HIV test (in case found positive, the Government of India norms do not permit
admission).
To report to the concerned Faculty/Department for verification of their original academic records,
entries and signature made in the Application form, completing other formalities and getting Admit
Card for depositing Additional Charges at the International Centre and obtaining Clearance.
To deposit the University fee within two-three days of provisional admission, failing which
admission shall be cancelled. It must be carefully noted that the fee shall not be accepted
after the date fixed for closure of admission.
To submit the photocopy of the fee receipt immediately to the concerned Dean/ Principle/Head/
Coordinator for entering his/her name in their records.
To fill up the Registration and Enrolment Form for enrollment in the University.
Procure the Identity Card from the Faculty/Department, fill up and get it signed by the respective
Head/Dean and the Warden (concerned Hostel for hostellers & City Delegacy (for non hostellers).
Fill up the Application form (to be obtained from the Central Library and the concerned hostel) for
library and hostel facilities (subject to its availability).

Registration with FRO:

Contact the Senior Superintendent of Police and Foreigners Registration Officer (Kotwali Premises, Near
G.P.O. Visheshwarganj) Maidagin, Varanasi within the stipulated period as mentioned on the Passport,
alongwith the Identity Card, Bonafide Student Certificate, issued by the concerned faculty/department
and duly countersigned by the International Centre.
Dos
abide by the guidelines issued from time to time by the Government of India/ University;
deposit the University fees at the appropriate time during entire duration of course;
to fulfill the attendance requirement for appearing at the examination;
absence from the University if any is subjected to the prior intimation and permission from the
concerned Head/Dean and Regional Officer, ICCR (in case of Councils scholar);
Further extension in the period of Students/Research Visa and changes (if any) is intimated to the
concerned Head/Dean and International Centre immediately.
Donts
Should not engage/involve himself/herself in any

Political or other controversial activities;

activities prejudicial to the interest of the host country;
and activities embarrassing the relations between the host country & any foreign country

NOTE:

All the admissions shall be provisional subject to Verification of copies of mark-sheet/certificates and
other documents with the originals by the respective Deans of the Faculties/Heads of the
Departments/Principal/ Coordinator with the original through the respective admission Committees.
In case they are satisfied about the genuineness of the document(s) then only provisional admission
shall be permitted.
However, the provisional admission is liable to be cancelled without any further notice forthwith at
any time during the entire period of the concerned course of study if at any stage it is detected that
the applicant has/had produced fake/forged certificate(s) /document(s), indulged in any act of
misconduct/ indiscipline/ moral turpitude and has/had concealed any other relevant information at
the time of seeking provisional admission. Such applicant is liable to be prosecuted besides being
debarred from admission in any of the courses of BHU in future.
All newly admitted students must get themselves enrolled pre ferably within a month of

admission, but in any case within the prescribed dates