UNIVERSITY OF THE PUNJAB

APPLICATION FOR ADMISSION IN Ph. D Admission Year-2011

Application Form No.(For
office use) Department/ Centre/ Institute/ College: IMPORTANT INSTRUCTIONS: Please read the Instructions carefully. 1. Incomplete application shall not be entertained. 2. See departments prospectus to choose program(s) and its eligibility. 3. Against each program there are choices of session and seat category. 4. You can tick more than one session and seat category, if that program is being offered in that session and with that seat category 5. See prospectus for the categories of seats and session for each selected program Sr. # 1. 2. 3. PERSONAL BIO-DATA: Degree /Program Morning

Photograph Passport Size

Date of Receipt.(For
office use)

3.

1. NAME:

2. NIC: 4. FATHERS NAME:

3. NATIONALITY:_________________________________________

5.

FATHER S OCCUPATION: 7. FATHERS NIC: 8. GENDER: 10. MARITAL STATUS: 11. PERMANENT ADDRESS: M F Married

6. MONTHLY INCOME:

9. DATE OF BIRTH: (dd/mm/yyyy) Unmarried

12. MAILING ADDRESS: (If different than above)

13. TELEPH ONE:

with area code

14. MOB ILE:

9.
15. RELIGION: ________________________________ 16. DOMICILE: 18. BLOOD GROUP: ________________________________ ________________________________ 17.E-MAIL : ______________________________________

10.
19. IF FATHER DECEASED, NAME AND ADDRESS OF GUARDIAN WITH RELATIONSHIP:

20. REGISTRATION NUMBER: Board:

University:

Proposed Program of Study

Degree/Qualification applied for Department in which you wish to study Ph. D.

Other Research

-----------------

Research Group/Topic (if known) Preferred Supervisor (if known)

21. ACADEMIC RECORD:

Examination Passed Matric/O level or Equivalent FA/FSc/A level or Equivalent BA / B. Sc / or Equivalent BS/ M. A./M. Sc./LLB/ Pham. D /MBBS /LLM/B. Com /BBIT/BBA or Equivalent MS/M.Phil/M. Sc. ( Engg) /MFA/LLM or Equivalent to 18 years education GAT (NTS) General GRE (NTS) General GRE Subject (USA) Other
*Board/University/College/School

Year

Examining Body*

Roll No.

Annua l/ Suppl.

GPA/Marks Total Obtain ed

Divisi on

Subject s

WORK EXPERIENCE:
Job Title Name of Organization Full/PartTime , etc. Nature of work BPS From To

DECLARATIONS AND SIGNATURE

Brief sketch of research work done so far including title of the project, name of the supervisor and the institution. Use additional pages if required The statements should not exceed 500 works. (Use separate sheet if required):

Please state briefly, if you have any special needs:

Please give reasons for choosing this program of study and University of the Punjab:

What are your future education plans?

Please give a brief statement about your interests and hobbies:

Have you ever been convicted? If yes, give details of all convictions.

Have you ever joined any Department / Institute / Centre / College / University of Punjab previously? If yes, give details.

PUBLICATIONS (if any) SHOULD BE SUPPORTED BY REPRINT / COPY.

Title of Paper Journal Volume Year Page

INSTRUCTION FOR APPLICANTS

1. All entries in the form must be made in block letters by the candidate in His /Her own handwriting. 2. Incomplete applications will not be accepted.
3. Each part /column of the application is to be filled, if any part/column is not applicable, write N/A against it.

4. Any candidate found to have made false or incorrect statement in the form is liable to expulsion.
5. Copies of all the relevant document must be attached with the application form 6. No benefit would be given for any document not attached with the application or produced after the closing date. 7. Unattested Copies of the Documents are admissible. 8. Applicants shall submit original documents to the Institution at the time of admission. 9. The filled-in complete Application Form shall be deposited in the concerned Department, or sent through Registered Post/ Courier Service. The Application Form must reach the Department by the last date given in Admission Notice advertised in the Newspaper & given on the University website.

10. CHECK LIST: Please Check; have you attached the following documents with the Application Form? Sr. # 1 2 3 4 5 6 7 8 9 DESCRIPTION Yes No

Copies of the Examinations Passed mentioned at Sr. No. 21 Copy of experience certificate from the employer. An original Migration Certificate (if applicable). (if graduated from a University other than the Punjab University) A certificate of good moral character. NOC from the employer (for employees only). Three recent passport-size photographs. A copy of CNIC & Domicile of the Applicant. A copy of CNIC of the Applicants Father / Guardian. Publications (if any). 10 Any other Please Specify. ( )

UNDERTAKING
1. SOLEMNLY DECLARE THAT:

i.
ii.

I have neither joined nor shall join any other Institute during the course of my studies at the Punjab University. I am not in service /am in service (score out which does not apply). (A letter of permission from the employer is enclosed) I am not suffering from any infectious disease. The entries made in this form are correct. SIGNATURE OF THE APPLICANT
Date: _______________________

iii.
iv.

2. UNDERTAKE TO:

i.

ii.

Abide by the Statues, Regulations (including the code of honour of Students, of University Calendar 1990 Vol. I) And Rules etc., framed by the University or the College/Institute/Department from time to time and shall be liable to any penalty including rustication / expulsion, in case of violation on my part; Show good behavior; Devote whole-heartedly to my studies and maintain the dignity and prestige of the University both in and outside the Campuses; Pay in time all dues and fines if any; That I undertake not to "indulge In politics", and, In case I violate this undertaking and "indulge in politics" after my admission by the University in any constituent College / Institute / Department, I shall be liable to expulsion from the College / Institute / Department without any notice under the order of the Vice Chancellor, which order shall be final and can be questioned only before the Supreme Court of Pakistan vide judgment / order of the Supreme Court of Pakistan dated 1-7-1992.

iii.
iv. v.

3. I am joining this class with the express consent of my father / guardian, who agrees to be responsible for my good conduct and has appended his signature below in token thereof. 4. I accept as binding on me, as long as I am a student, all Rules and Regulations in force at the time of joining and which might be framed subsequently.

5. I accept as a condition of my admission the authority of the University that a student can be

required to withdraw his/her name from the rolls, if in the opinion of the ViceChancellor/Principal/Chairman of the Department / Director of the Institute, his/her stay is not conducive to the welfare, either of himself/herself or others in the College / Department / Institute, if I fail to withdraw my name immediately, after being called upon to do so, it may be struck off the rolls of the College / Department / Institute without any further notice to me.

6. I am at present staying with my parents / guardian / relative, in a recognized hostel / private lodging at the following address, and shall notify the new address, if there is any change. 7. I undertake to take examination unconditionally every year as scheduled subject to any change whatsoever notified by the University. 8. I HAVE READ THE RELEVANT RULES AND REGULATIONS CONCERNING ADMISSION BEFORE SIGNING THIS APPLICATION.

________________________________ SIGNATURE OF FATHER/GUARDIAN Dated: __________________________

Attach attested photocopy of National Identity Card of Father / Guardian

_____________________________ SIGNATURE OF THE APPLICANT Dated: ______________________ Permanent Home Address:_____________________________ __________________________________________________ _________________________________________________ Telephone_________________________________________

Permanent Home Address:_____________________________ ______________________________________________ ____ ______________________________________________ ___ Telephone____________________________________ _____

Acknowledgement Receipt
Admission Form No. _______________________ Year: _______________________ Session: __________________

Department/ Centre/ Institute/ College:________________________________________________________________

Name of the applicant: ______________________________________________________________________________________ Son/Daughter of ___________________________________________________________________________________________ Date of Receipt: _________________________ Checked and Received by (Signature): _______________________________________