Application No.

DR. B. R. AMBEDKAR OPEN UNIVERSITY

Road No. 46, Prof. G. Ram Reddy Marg, Jubilee Hills, Hyderabad 500 033

Application for Admission into

Master of Philosophy (M.Phil.)/Doctor of Philosophy Programme (Ph.D.)

1. PROGRAMME

i) Ph.D./M.Phil.

ii) Subject

2. NAME: First Name

Middle Name
Surname

3.

FATHERS/
MOTHERS NAME

4.

DATE OF BIRTH
DD

5.

GENDER:

6. SOCIAL
CATEGORY
[Please tick []

7. Are you employed?

MM

YYYY

Male

OC

Female

BC-A BC-B BC-C BC-D BC-E

Yes

SC

ST

PH

No

If employed, mention

Designation: ......

Name & Address of the Organization: ....

...
...
...

8. EDUCATIONAL QUALIFICATIONS
(Tick the relevant box(s) and write the subject in the blank space)
8.1

Qualified at the UGC-CSIR/JRF/NET/SLET/GATE exam in the subject _____________

8.2

M .Phil. in the subject of ____________________________________________________

8.3

Post-graduation with 55% marks and above in the subject of _______________________

8.4

Post-graduation with 50% marks and above in the subject of _______________________

8.5

Any other (specify the programme & subject) __________________________________

Total Marks in Post-graduation

Marks Secured

Percentage of Marks
* For the calculation of percentage of marks, marks of all the subjects/papers of the
postgraduate programme mentioned will be taken into consideration irrespective of
respective universitys method to calculate the percentage.
9. Proposed Topic for the Ph.D. programme: (Enclose a research proposal on separate sheets)
.......
...
10. Articles published, if any: (enclose published articles)
...
...
11. Mention the Registration fee particulars:
DD. No.... Date.. Amount .....
Bank. Branch Place.....
(Please pay the required fee in the form of Demand Draft from a nationalized bank drawn in favour of
The Registrar, Dr. B. R. Ambedkar Open University, payable at Hyderabad).
12. Affix Passport-size Photograph and signature in the space given below:

Paste Your
Latest
Passport Size
Photograph

Signature of the Applicant

12. ADDRESS FOR CORRESPONDENCE

Name: ....
Full Address: .....
........
Pin Code
Phone (with STD code) : .
E-mail ID

: .

Mobile No.

: .

13. DECLARATION BY THE APPLICANT

I hereby declare that all the particulars furnished above are true and correct to the best of my
knowledge. I am aware that if any particulars furnished by me are found to be false or incorrect on
scrutiny or at any stage, my application may be liable for rejection. Even my admission granted based
on such incorrect information may be cancelled.
Date :
Applicants Signature : .
N.B.: The filled in Application along with the supporting documents such as Degree Certificate,
Memo of Marks, Experience Certificate, Publications, Research Proposal etc. should reach The
Director (Student Services, Dr. B. R. Ambedkar Open University, Road No. 46, Jubilee Hills,
Hyderabad-500033 on or before_______________.
Check List of enclosures. Tick ( ) the relevant boxes against your enclosures
Relevant Certificate(s) of Qualifying
Examination
Memo randum of Marks of Post-graduation
Examination
UG UGC/ CSIR/JRF/ NET/SLET/ GATE/M.Ph il. Cert ificate if qualified
Give the list of other enclosures (if any)
Examination

1.

..

2.

..

3.

..

Research Proposal (only for Ph.D.)

Photo copies of Articles published
Demand Draft
One spare Passport size Photograph