1.
Department /Centres to which applying for 1.__________________________________
2.__________________________________
2.
Name of the candidate in full
3.
Proposed Research area
____________________________________
____________________________________
4.
Category of studentship ____________________________________ i.
Full time Research Scholar with University.
Fellowship/Assistantship/scholarship /Teaching assistantship. ii.
Full time Research Scholar with external fellowship(UGC/CSIR etc) iii.
External candidates (sponsored) as sponsored Research Scholar. iv.
University full time Faculty v.
Project Staff(JRF/SRF/RA etc.) vi.
Full time Research Scholar without Fellowship(self financed/self supported) vii.
Sponsored Student
5.
Address for Communication
________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Tel. No. _________________________________Email ID _________________________________
6.
7.
Date of Birth
Sex : Male /Female 9. Marital Status :Married /Single
10. Nationality _______________________________________________________________________
11. Academic career (Enclose photo copies of the qualifying degree certificate and mark sheets/grade cards showing the percentages of marks (CGPA)
Name of Examination Institute /University Year of passing Percentage of
Marks/CGPA

12. Gate / NET Score : Subject _____________ Score : _________________Year : __________
13. Experience
Organization Position Duration Nature of Job
1.
Previous Research work and publication , if any (Enclose copies of published or unpublished work)
2.
Record of past study as a sponsored candidates , or other contractual obligation , if any
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
I do hereby declare that the information furnished in this application is true to the best of my knowledge and belief. If admitted, I shall abide by the rules and regulation of the institute and Hall attached to it. If any information furnished in this application is found to be untrue , I am liable to forfeit the seat allotted to me any time in future and legal action be taken against me.
Full signature of the applicant.
NB: Draft of Rs. 1000/- (One thousand only) to be attached in favour of Siksha “O’ Anusandhan
University , payable at Bhubaneswar.