JAWAHARLAL NEHRU TECHNOLOGICAL UNIVERSITY ANANTAPUR

ANANTHAPURAMU 515 002, (A.P.)

APPLICATION FORM FOR ADMISSION INTO FULL TIME / PART TIME Ph.D.
RESEARCH PROGRAMMES FOR UGC-JRF/ UGC-CSIR-JRF/ GATE/GPAT WITH VALID
SCORE/ FDP QUALIFIED CANDIDATES
( Please go through the Instructions to the candidates before filling up the application form)

Last Date for Receipt of Applications 10-02-2020

BYby 5.00 PM

Details of Demand Draft in favour of “The Registrar, JNT University Anantapur ” payable at
Ananthapuramu

D.D.No. Date Issuing Bank details Amount (Rs.)

1500/-

Faculty / Discipline as given in the instructions

Full Time/ Part Time
(in case of interdisciplinary mention both)

1. Name (In block letters) :_______________________________________

(As per S.S.C or equivalent)
Affix attested recent
2. Father’s/Husband’s Name _____________________________________ Passport size photo

3. Address : __________________________________________________

___________________________________________________

___________________________________________________

Mobile No. : ___________________________________________

E-mail ID : __________________________________________________
(Please write the e-mail address correctly and legibly)

4. Date of Birth: Gender: Category:

Date Month Year Male Female OC BCA BCB BCC BCD BCE SC ST OC-
EWS
                       
[please put a ( √ ) mark in the appropriate box; if claiming any reservation, enclose relevant reservation certificate ]

5.Residential Status: Local Non-Local Other State

6. a) Details of Academic Qualifications : Starting from S.S.C. (Please enclose Xerox copies of all Marks
Statements & Degree certificate. Otherwise the application will be rejected).

Exam Subject/ College/School University / Year of Aggregate

Specialization where studied Board passing with Percentage/
Division CGPA

b) Details of UGC-JRF/UGC-CSIR-JRF/GATE/GPAT WITH VALID SCORE/ FDP SCORE/ RANK (if

any):
Name of the Examination Qualified:
Validity : From___________________ up to _______________________

7. Details of employment : (Applicable only for Part Time Ph.D. Applicants)

(Particulars of employment(s) from date of passing prescribed qualifying Examination till last date of
application shall be provided. Enclose Certificates).

Name of Employer / Duration of Employment

Organisation Designatio Salary Nature of duties
n last drawn
From To in years
&
Months

8. Declaration by the Candidate :

I shall abide by the Academic Regulations of the JNT University Anantapur, Ananthapuramu. The
particulars furnished above are correct and complete to the best of my knowledge.
I have not registered for any other course leading to degree in any other University or Institution and I shall
not register during research period

Date :
Place :
SIGNATURE OF THE CANDIDATE

Note:- Candidates are advised to visit University website regularly for further updates .