To be sent to the concerned Department in the University or the College where admission is sought

Serial No.:

BHARATHIDASAN UNIVERSITY
TIRUCHIRAPPALLI 620 024. TAMILNADU Application form for Admission to M.Phil. Programme
For Office Use Only (C/D)50 X Y 2. Subject

FULL TIME/PART TIME

Last dater for receipt of filled in Application in the University.

A B C D (A/B)20 Z Score Placement

1. Name of the Candidate

3. Name of the College/University Department

4. Address for Communication Pin________________ 6. Sex 7. Community

M F

Employment Address Pin______________________ 8. Nationality

Indian Other

5. Date of Birth
D M Y

SC ST MBC BC OC

9. If College Teacher 10. If others for Part-Time 11.Extra-Curricular Activity 12. Physically Handicapped
FIP PT PG UG HSS Govt. Oth Exp NSS NCC Sports 14. Occupation Yes No

13. Name of the Father/Guardian

15. Educational Qualifications

PG Degree UG Degree Register Date of Number Passing Register Date of Number Passing Total Marks for all Papers Max Total Marks for all papers Max College & University Atm College & University

16. Whether registered for any other course in this or any other University, if so, give details

17. If working, the Signature of the Head of the Institution

19. Date

18. Signature of the Candidate

Note: The DD Should be sent to the Registrar along with the Application.

To be sent to the REGISTRAR Bharathidasan University Tiruchirappalli

Serial No.:

BHARATHIDASAN UNIVERSITY
TIRUCHIRAPPALLI 620 024. TAMILNADU Application form for Admission to M.Phil. Programme
For Office Use Only (C/D)50 X Y 2. Subject

FULL TIME/PART TIME

Last dater for receipt of filled in Application in the University.

A B C D (A/B)20 Z Score Placement

1. Name of the Candidate

3. Name of the College/University Department

4. Address for Communication

Employment Address

5. Date of Birth
D M Y

Pin________________ 6. Sex 7. Community

M F

Pin______________________ 8. Nationality
Indian Other

SC ST MBC BC OC

9. If College Teacher 10. If others for Part-Time 11.Extra-Curricular Activity 12. Physically Handicapped
FIP PT PG UG HSS Govt. Oth Exp NSS NCC Sports 14. Occupation Yes No

13. Name of the Father/Guardian

15. Educational Qualifications

PG Degree UG Degree Register Date of Number Passing Register Date of Number Passing Total Marks for all Papers Max Total Marks for all papers Max College & University Atm College & University

16. Whether registered for any other course in this or any other University, if so, give details

17. If working, the Signature of the Head of the Institution

19. Date

18. Signature of the Candidate

Note: Duplicate along with the photo copy of the DD should be sent to concerned Dept./College..