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7/28/2019 form_pg_mphil_2013_2014

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DECLARATION

I SOLEMNLY UNDERTAKE to accept and abide by the rules of the Jamia Millia Islamia and all the decisions of the

Admission Committee and other appropriate University bodies in regard to my admission.

I SOLEMNLY AFFIRM that I have never been convicted by a court of law nor rusticated/expelled from any educational

institution nor disqualified/debarred from any examination.

I will accept the cancellation/forfeiture of my candidature in case any information supplied by me in this form is found to be

incorrect at the time of admission or thereafter.

Date................................... Signature of the Applicant

DECLARATION BY THE PARENT/GUARDIAN

I certify that the above particulars are correct. I agree that in the event of my son/daughter/

ward............................................................. being admitted to the Jamia Millia Islamia, New Delhi, I shall pay dues

and all personal expenses until the completion of the applicants studies. I also undertake full responsibility for the good

behaviour and conduct of the applicant.

Date.............................. ..........................................................

Signature in full of the Parent/Guardian

Relation with student.....................................................

Address......... .......... .......... ............. .......... .......... .........

...................................................................................

Telephone No................................................................

E-mail..........................................................................

INSTRUCTIONS

1. Code for Category:

G General M Muslim General MW Muslim Women

MO Muslim OBC MT Muslim ST PD Persons with Disabilities

J Jamia* K Kashmiri Migrant

* Jamia as category of reservation shall only be applicable to courses for which qualifying examination is obtained

from Jamia Schools as provided in Jamia rules.

No change of category is permiss ib le, once the choice has been made.

2. In case of downloaded Application Form a Bank Draft/Pay order (of a bank having its branch in New Delhi) should be

made in favour ofJamia Millia Islamia, payable at New Delhi. Candidate must write his/her name and number of his/

her Application Form on the back of the bank draft/pay order/cash receipt on top left conrner.

3. Filled Application Form complete in all respect along with the Bank Draft/Pay order, should be submitted in the office

of the Dean of the respective Faculty/Department/Centre by the last date indicated in the Prospectus.

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JAMIA MILLIA ISLAMIA

Jamia Nagar, New Delhi-110025

Admit Card for Entrance Test 2013-2014

Course applied for: ................................................. Dept./Faculty .............................

Name (In Block Letters):......................................................................................................Fathers Name:.............................................................................................................

Mothers Name:.............................................................................................................

Address:........................................................................................................................

....................................... .......................................

Signature of Applicant Signature of Invigilator

FOR

CENT

RE

JAMIA MILLIA ISLAMIA

Jamia Nagar, New Delhi-110025

Admit Card for Entrance Test 2013-2014

Course applied for:................................................. Dept./Faculty .................................

Name (In Block Letters) : ..........................................................................................................

Fathers Name:..................................................................................................................Mothers Name:.................................................................................................................

Address:............................................................................................................................

....................................... .......................................

Signature of Applicant Signature of Invigilator

Note: Contact the Concerned Dept /Faculty for venue of Entrance Test.

Acknowledgement Slip

Received an Application Form from (Candidates Name) ............................................................ for admission

to ................................................................................................course.

...........................................................

Date................................. Signature of receiving official with Stamp

FOR

CANDIDATE

Cut Here

Cut Here

Affix your recentself attested coloured

photograph

(Size 2.0 x 1.5)

It should be pasted with gum

and covered with

transparent tape

Affix your recent

self attested coloured

photograph

(Size 2.0 x 1.5)

It should be pasted with gum

and covered with

transparent tape

Form No.

Roll No.

(To be filled by the office)

Form No.

Roll No.

(To be filled by the office)

Form No.