Beruflich Dokumente
Kultur Dokumente
exe
UNIVERSITY OF HYDERABAD
Basic Data Form - 2011
Hall Ticket Number Application Form No.
1. Read the instructions carefully before filling the form (to be filled by the office)
2. Use only CAPITAL letters
3. Please Tick (9
9) the relevant box
Position regarding the results of If the result of the qualifying degree is Distinction in Sports / Cultural activities
already declared indicate % of Marks (Attach copies of the certificates)
the Qualifying Examination
EP RA NA State Level National Level
for 5 year integrated & PG courses only for M.Phil / Ph.D. only
for M.Tech. and Ph.D. in Electronics Science only
Are you a Scholar of KVPY/Science Olympaid/
JRF/RGNF qualified
IIT JEE Ranker / I ranker at +2 Boards GATE Subject GATE Score
YES NO YES NO
If yes, Enclose a copy Enclose a copy of GATE Score Card If yes, enclose a copy
DO NOT STAPLE
Signature of the Candidate
PIN :
DO NOT STAPLE
Specimen Signature of the Specimen Signature of the Candidate
Father / Mother / Guardian
7. a) For 5 year integrated & PG courses only b) For M.Tech. and Ph.D. in Electronics Science only c) JRF/RGNF qualified
Are you a Scholar of KVPY/Science Olympaid/
IIT JEE Ranker / I ranker at +2 Boards GATE Subject GATE Percentile Score (for M.Phil / Ph.D. only)
Yes No . Yes No
If yes, Enclose a copy Enclose a copy of GATE Score Card If yes, enclose a copy
Inter /
HSC ............
(10 + 2)
Any other
Degree / .............
Diploma
BE/B.Tech./
.............
M.C.A. etc.
1
12. State if there was any gap in your studies. Give period, reasons etc:
------------------------------------------------------------------------------------------------------------------------------------------------
c) Have you qualified in the UGC/CSIR National level test for JRF ? Write, Yes or No
(also, NBHM fellowship test in case of admission to Ph.D. Mathematics and ICMR/ICAR/DBT
fellowship tests in case of Ph.D admission in the School of Life Sciences) or possessing RGNF
e) Are you seeking exemption from appearing in the written test on the basis of Write, Yes or No
your having qualified in UGC/CSIR JRF test/NBHM/ICMR/ICAR/DBT
Fellowship test/RGNF/GATE for admission to Ph.D. in Electronics Science.
f) Write whether you are applying for Regular, Part-time or External Registration to Ph.D. …………....................
Note: Candidates with UGC-NET for lectureship alone and possessing M.Phil./M. Tech. Degree are not exempted
from the written test
16. Were you ever subjected to a disciplinary action by any authority ? Write, Yes or No
2
18. DECLARATION BY THE APPLICANT:
I hereby declare that all the information furnished by me in this application and in the documents I have submitted in support
of my application are true, complete and correct. In case any information in this application is found to be false or incorrect
at any time (during or after completion of the course), this shall entail automatic cancellation of my admission, if granted,
cancellation of the degree if awarded , besides rendering me liable to such action as the University may deem fit.
In the event of any medical or other emergency, my parent/s or Guardian may be contacted at the address given below
Place:
Note: Signature of the candidate and the parent in this application form will be considered as the basis for all verification
purposes in the University.
......................................................................... ..........................................................................................
........................................................................ ..........................................................................................
........................................................................ .........................................................................................
....................................................................... .........................................................................................
PIN PIN