Application Form for Admission in Ph.D.

Programme
PANDIT DEENDAYAL PETROLEUM UNIVERSITY
(Recognized By UGC)
Raisan, Gandhinagar - 382007. Gujarat, India.
Phone :+91 - 79-23275060 Fax : + 91 -79-23275030
www.pdpu.ac.in
To
The Registrar
Pandit Deendayal Petroleum University
P.B.No. 3, Raisan, Gandhinagar - 382007
Sub: An application for Ph.D. Admission January 2016 in the School of _____________________________________________
(Technology/Liberal Studies/Petroleum Technology/ Petroleum Management)
in the
relevant area of ____________________________________________________ (Please refer the admission policy on the Website)
Sir,
With reference to your advertisement published in recent for Ph.D. Admission, I hereby would like to apply for the same as per the following
details :

Application No.
PLEASE AFFIX YOUR
SIGNED PHOTOGRAPH
HERE

Full Time/Part Time

For Office Use only

1. Name of the candidate as per Std. 12 marksheet (In Block Letters)

Male

2. Gender :

Female

Transgender

3. Date of Birth :
day

4. Physically Challenged :

5. Nationality :

Indian

Correspondence
Address
City/Town

State

Country

PIN Code
STD Code

Phone No.

Mobile :
E -mail Address
for Correspondance :
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Ph.D. Admission January 2016 : PDPU

Year

North-East Indian

Foreign

(Tick wherever applicable.)

Landline No.:

Month

Permanent
Address
City/Town

State

Country

PIN Code
STD Code

Phone No.

Landline No.:

Academics
Examination

Degree

University/Board

Principle Subjects

Year of Passing

Percentage/
CGPA

SSC
HSC
Bachelor
Degree
Master Degee
Any Other

Test
A) (If you are qualified with * UGC NET/JRF/GATE/CAT/XAT/MAT/CSIR or such other examination, please provide hereunder
the information)
Qualified with *

Date of Qualifying

Valid up to

Score

Subject/s Taken

Professional Experience (Teaching/Research/Industrial), if any

Name of Organization

Position held

Type of work

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Ph.D. Admission January 2016 : PDPU

Period

Explain your research interest/area (Statement of Purpose) in 150 words

References
Name

Application Fee :

Designation & Address

E-mail ID

Phone No.

Issuing Bank (with Address)

Demand Draft No.

How you come to know the admission announcement:________________________________

Declaration
I hereby declare that the information provided in this application form are correct to the best of my knowledge and understanding. In case of
any information furnished by me if found to be incorrect and/or to be not in compliance to the rules of the University, the University has the
right to take any action it deems fit, including the cancellation of the admission at any point of time. If selected for admission, I promise to
abide by the ruies and regulations of the University in force from time to time. I also assure hereby that I shall not indulge into ragging in any
form. I have read the admission policy-procedure on the website, to which I abide to follow.
Date :
Place :
Signature of the Candidate
Note :
(i)

The duly filled in application form is to be sent by registered/ Speed Post/DTDC Courier along with Demand Draft of Rs.2000/(Non Refundable)in favor of "Pandit Deendayal Petroleum University" payable at Ahmedabad, to the University on or before the
prescribed last date, alongwith the self attested photocopy of all necessary testimonials.

( ii )

Name and address of the candidate is to be written at the back of the DD and the envelope must be superscribed as "Ph.D.
Admission January 2016".

(iii)

The selected candidates who wish to pursue interdisciplinary research will be registered in a department of School of Technology
relevant to the area of their qualifying PG degree.

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Ph.D. Admission January 2016 : PDPU

To be filled by the Candidate and be submitted alongwith the Application Form

PANDIT DEENDAYAL PETROLEUM UNIVERSITY
Ph.D. ADMISSION JANUARY 2016
ADMIT CARD Part-A

For Office Use

Candidates Name:
Paste passport
size photograph

Parents /Guardians Name:

Address:

Signature of the Invigilator

Signature of the Candidate

For Office use only.

(To be signed by Invigilator present at Test Centre after identity
verification.)

( To be signed by the applicant in presence of the

Invigilator at the time of appearing for the test.)

__________________________

Signature of the Candidate

__________________________

Date of Admission test: 18th December 2015

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

To be retained by the candidate & to be produced while appearing at the examination

PANDIT DEENDAYAL PETROLEUM UNIVERSITY
Ph.D. ADMISSION JANUARY 2016
ADMIT CARD Part-B

Paste passport
size photograph

Candidates Name:
Parents /Guardians Name:
Address:

Date of Admission test:

18th December 2015

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