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 (Ph.D.) Programme

1. PROGRAMME i) M.Phil./Ph.D. ii) Subject

2. NAME: First Name

Middle Name

Surname

3. FATHER’S/
MOTHER’S NAME

4. DATE OF BIRTH

DD MM YYYY

5. GENDER: Male Female

6. SOCIAL
OC BC-A BC-B BC-C BC-D BC-E SC ST
CATEGORY
[Please tick [√]

7. Any other category (example: PH)

8. Are you employed? Yes No

If employed, mention

 Designation: ..……………….………………………………….……………..………………

 Name & Address of the Organization: .…………………………………………..………….

………………………………………..…………….
………….………………………………………..…
………….………………………………………..…
9. 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 the
respective university’s method of calculating the percentage.

10. Proposed Topic for the Ph.D. programme: (Enclose a research proposal)
..………………………………………………..………….……….……………………………….……
.………………………………………………………………………………………..…………………

11. Articles published, if any: (enclose published articles)

…………………………………………………………….……….……………………………….……
.………………………………………………………………………………………..…………………

12. 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”).

13. Affix Passport-size Photograph and signature in the space given below:

Paste Your
Latest
Passport Size
Photograph

Signature of the Applicant

14. ADDRESS FOR CORRESPONDENCE / PERMANENT

Name: ………………………………………………………….………………………...……………
Full Address: …………………………….……………………………………………..…..…………
….…………….……………..…………………………………………………….……..…………….
…………………………………………… Pin Code

Phone (with STD code) : …………………………………………………………………….

E-mail ID : …………………………………………………………………….
Mobile No. : …………………………………………………………………….

15. 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 : Applicant’s 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 (Academic), Dr. B. R. Ambedkar Open University, Road No. 46, Jubilee Hills,
Hyderabad-500033” on or before 18.06.2018.

Check List of enclosures. Tick ( √ ) the relevant box(s) against your enclosures

Certificate(s) of Qualifying Examination

Memorandum of Marks of Post-graduation

Examination
UG UGC/CSIR/JRF/NET/SLET/GATE/M.Phil. Certificate (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