Application Form For M.phil/ph.d. Course Work And Integrated Pre-Ph.d.course
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1
2ASSAM UNIVERSITY, SILCHAR, ASSAM (INDIA)
APPLICATION FORM FOR
st
M.Phil/Ph.D. Course work and Integrated Pre-Ph.D.Course (1
Semester)
EXAMINATIONS………………………
Department_____________________________
Photo
Roll__________________ No.______________
(To be filled by the University)
To,
The Controller of Examinations, Assam University
Through the Dean, School of …………………………………………………………..Assam University, Silchar
Sir,
I request you for permission to present myself at the ensuing …………………………………… M.Phil/
st
Ph.D. course work or integrated Pre-Ph.D (1
Semester) Examination to be held in the month of
…………………… 20………The Fee receipt is enclosed herewith .
I testify that , to the best of my knowledge and belief all the statements made by me are true and
correct. If any of the statements made in the application is incorrect in the opinion of the authority of the
University or I have in any way contravened the provision of the University Rules and Regulation relating to the
Examination my application shall be liable to be cancelled by the authority of the University at any time .
Yours obediently
Date………………
Signature…………………………………………….
Name in full………………………………...…………
(Block Letter)
Present Address……….………………………………
……………………..……………………………………
CERTIFICATE
Certified that the above mentioned candidate has fulfilled all the eligibility criteria to appear for the above
Examination and that he/she.
(i)
Completed the class work
(ii)
Has paid the prescribed Examination fee & other dues.
(iii)
Nothing is known against his/her conduct and character which dabars him/her from appearing in the
examination.
________________________________
Place……………………
Signature of the Head of the Deptt.
Date…………………….
(Seal)
Forwarded the application form of Examination……………………….……………………in respect of
…………………………of………………………Department along with the copies of requisite documents for
necessary permission to sit at the ensuing Examination.
Place……………………
Signature of the Dean of the School
Date……………………..
(Seal)
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