Shivaji University,Kolhapur

M.Phil./ Ph.D. 2021-22

Application Number : - 4008

To,
The Registrar,
Shivaji University,Kolhapur-416004
Sir,
I am applying herewith for M.Phil./ Ph.D. 2021-22
Ph.D. Entrance examination.
Application Number : - 4008 User Name : - krajendra81
Course Name : - Ph.D.
Subject : - Civil Engg.

Exam Center : - Sangli Center

P.G.Percentage : - 62.38
Candidate Name : - KAMBLE RAJENDRA SHIVAJI
Father/Hasband Name : - SHIVAJI Mother Name Geeta

Current Address : - Vinayak nagar

Vishrambag Sangli

Permanent Address : - Vinayak nagar

Vishrambag Sangli

Telephone No. : - 9967414837 Mobile No. : - 9967414837

Email ID : - rajendrakamble815@gmail.com
Present Occupation : - Civil Engineer
M.Phil Pass : - NO NET Pass : - No SET Pass : - No
SLET Pass : - No GATE/GPAT Pass : Yes UGC-JRF/SRF Pass : - No
Birthdate : - 25-May-1981 Gender : -Male Maritial Status : - UnMarried
Caste Category : - SC Physically Handicapped : No Nationality : - Indian
Ex-Serviceman. : - No
Graduation Details : -

Name of College / Institute University Examination Passing Seat No. Perc. % Subject Offered
Year
-WCE Sangli -BE -BE Civil
Shivaji University 2005 -6062 59.73

Post Graduation Details : -

Name of College / Institute University Examination Passing Seat No. Perc. % Subject Offered
Year
-SPCE Mumbai -ME Structural Engg
Other -ME 2011 -137 62.38

Fee Details : -

Amount Payment Receipt No. Receipt Date Method of payment UTR No.

VICI0093823868
600 3518 2021/07/06 03:54:41 PM Other bank net banking

DECLARATION
I have been provisionally permitted to appear for entrance examination based on the information furnished above. I will produce all the
relevant certificates/documents at the time of interview,failing to which my candidature will be liable to be cancelled at any stage.
I hereby declare that I shall refrain from engaging in any behavior or activity that is prohibited as per the University regulations

Place : -

Date : - ( Signature of the Candidate )

Note:
1. Print out of this application need not be sent to university.
2. Incomplete form will not be considered for further process.
3. Hall Tickets will be made available on your login ID before five days of schedule of entrance examination.
4. Those Candidates who wish to apply for following subjects need to read following instruction carefully
 Shivaji University,Kolhapur
M.Phil./ Ph.D. 2021-22

Application Number : - 4008