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Annexure-I

JAMIA MILLIA ISLAMIA


Jamia Nagar, new Delhi-110025
APPLICATION FOR ADMISSION TO THE
DOCTOR OF PHILOSPHY (Ph.D.) PROGRAMME
The Chairman,
Board of Studies/ Committee of Studies,
Department/ Centre of
Faculty of ..
Jamia Millia Islamia, New Delhi 110025

Affix here
a Recent
Self-Attested
Photograph

Sir,
1.

I am applying for admission as research scholar to the Ph. D. programme in


................. under the Faculty of/ Centre for .
and submitting the following particulars in support of my application along with a crossed
Demand Draft of Rs. 1000/- vide no. . dated , issued by
(Bank) .. .

2.

I would also like to be considered for admission as research scholar to the Ph.D. programme
in .. Department/Centre/Faculty, as my subject of Post graduation is
being considered as an allied subject in the Department/Centre/Faculty as mentioned below in
Note A of this application form.
Yours faithfully,

Date

(Signature of the Candidate)


Name: .

(PARTICULARS TO BE FILLED BY THE CANDIDATE)


Category (see Note (B) for category code): ....................
Name of the Candidate

..

Fathers Name

....

Mothers Name

..........................

Name of Spouse (if married) ...............


Date of Birth (as given in the Matriculations/ Secondary School Certificate)

...

Nationality.. Jamia Enrolment No. (if any)


..
Permanent Address............................................................................................................................
...............
......................
Local Address (with proof of residence). ..
.. .....
. ..
Telephone with STD code: ...
Mobile:
E-Mail: ..
1

DETAILS OF PREVIOUS EXAMINATIONS


Exam Passed
Name of the
University
UG Course
PG Course

Year of
Passing

Division &
Percentage

Subjects

M.Phil.
Any Other
Proposed Topic of Research
.
Details of Research experience, if any (Attach separate sheet, if necessary) ....
Languages, which the candidate knows
.
If employed, write the name of the institution and the position held .....

I declare that the information provided above are true in all respect.

Dated

(Signature of the Candidate)

(RECOMMENDATION OF THE BOARD OF STUDIES/ COMMITTEE OF STUDIES)


The Board of studies/ Committee of Studies held on recommended Shri/ Smt./ Km.
For admission to the Ph. D. Course
inon the topic ...
. ......
under the supervision of .. .

Chairman Board of Studies/ Committee of Studies


Department/ Centre/ Faculty .....

(APPROVAL OF THE DEAN OF THE FACULTY/ DIRECTOR OF THE CENTRE)

Dated

Signature of the Dean/ Director with Seal

Note:
(A) Allied Subjects: To ensure the correct choice of the allied subjects refer to Ph.D. Admission
2013-14 at JMI website (www.jmi.ac.in) under Ph.D. admissions no. of vacancies.
(B) If a candidate is applying for admission to Ph.D. programme in two Departments/Centres/
Faculty, he/she will be required to submit separate Research Proposal in the respective
Departments/Centres/Faculty, by the due date (as per the schedule).

(C) The following documents will have to be submitted at the time of submitting the application form.
1.
2.
3.
4.
5.

Attested copies of all Mark Sheets and Degrees of Graduation and Post Graduation Examinations.
Proof of the date of birth.
Proof of claimed reserved category.
An attested copy of M.Phil. Marks Sheet/ Degree (in case of exemption from the Entrance Test is required).
An attested copy of UGC NET/SLET or an equivalent examination (in case of exemption from the Entrance
Test is required).
6. An attested copy of valid GATE Score Card.

(D) Category Code:


G:
M:
MW:
MO:
MT:
PD:

General
Muslim
Muslim Women
Muslim OBC
Muslim Scheduled Tribe
Persons with Disability

If at any stage it is found that the applicant has provided false/incorrect information, his/her
application is liable to be rejected and admission (if granted) will be cancelled.

FOR CENTRE

JAMIA MILLIA ISLAMIA

Form No.

Jamia Nagar, New Delhi-110025


Admit Card for Entrance Test 2013-2014

Roll No.
(To be filled by the office)

Course applied for: ................................................. Dept./Faculty .............................


Name (In Block Letters):......................................................................................................
Fathers Name:.............................................................................................................
Mothers Name:.............................................................................................................
Address:........................................................................................................................

Affix your recent


self attested coloured
photograph
(Size 2.0 x 1.5)
It should be pasted with gum
and covered with

.......................................
Signature of Applicant

.......................................
Signature of Invigilator

FOR CANDIDATE

transparent tape

Cut Here

JAMIA MILLIA ISLAMIA

Form No.

Jamia Nagar, New Delhi-110025


Admit Card for Entrance Test 2013-2014

Roll No.
(To be filled by the office)

Course applied for:................................................. Dept./Faculty .................................


Name (In Block Letters) : ..........................................................................................................
Fathers Name:..................................................................................................................
Mothers Name:.................................................................................................................

Affix your recent


self attested coloured
photograph
(Size 2.0 x 1.5)

Address:............................................................................................................................It should be pasted with gum


and covered with
transparent tape

.......................................
Signature of Applicant
Note:

.......................................
Signature of Invigilator

Contact the Concerned Dept /Faculty for venue of Entrance Test.

Cut Here

Acknowledgement Slip

Form No.

Received an Application Form from (Candidates Name) ............................................................ for admission


to ................................................................................................course.

Date.................................

...........................................................
Signature of receiving official with Stamp