Application Form for Registration for Ph

							                                                                       NUEPA
                                                                (Declared by the GOI under Section 3 of the UGC Act, 1956)
                                   17-B, Sri Aurobindo Marg, New Delhi 110 016, INDIA

              (Application Form for Registration to M. Phil. / Ph. D. Programmes, 2007-08
                                        (for Indian Nationals)
1. Name (in BLOCK letters)             ______________________________________________
2. Sex                                 Male / Female
3. Marital Status                      Married / Single
                                                                                                                                 Recent Passport
4. Father’s Name                       ______________________________________________                                            size photograph
5. Mother’s Name                       ______________________________________________
6. Guardian’s Name                     ______________________________________________
7. Date of Birth

                                            Date                   Month                                 Year
8. Category                            General / SC / ST / OBC / Person with Disabilities / Any other _________________________
                                       (Please enclose copy of the Certificate, if applicable)
9. Permanent Address                   ___________________________________________________________________________
                                       ___________________________________________________________________________
                                       ___________________________________________________________________________

10. Address for Correspondence ___________________________________________________________________________
                               ___________________________________________________________________________

                                       Phone: ______________________ Email ID: ______________________________________
11. Educational and Professional Qualifications

    Examination                  Name of the                    Year of                     Subject offered                    Division/   % of
      passed                   Board/University                 Passing                                                         Grade      marks
 High School
 Intermediate/
 Hr. Secondary
 Graduation
 Post Graduation
 M. Phil
 Any Other
(Please enclose copies of the Marks Sheet and Certificate of all the Examinations)
12. (a) Whether NET qualified          Yes / No                              (b) Has UGC/CSIR fellowship under JRF category                Yes / No
    (If yes, please enclose relevant documents)
13. Area of Research Interest in Educational Planning and Administration: ____________________________________________
    (Please refer Prospectus for details)
14. Please submit three copies of the brief write-up on the proposed area of research interest in educational planning and
    administration in about 2500 words in separate sheet.
15. Please indicate the type of programme:           M. Phil.              Full Time Ph. D.                 Part Time Ph. D.

Date: ________________                                                                                                                     Signature
                             Note: Complete Application Form along with necessary enclosures should be sent to the
                     Registrar, NUEPA, 17-B, Sri Aurobindo Marg, New Delhi-110 016. Envelope should be distinctly marked as
                                  ADMISSION FOR M. Phil, Full Time Ph. D. or Part Time Ph. D. Programme, 2007