You are on page 1of 2

si

qnrvBE wiieqr ?R?zqs1u+o,


w\t"fpr"

aFuR qBff

TiCf: H.qr.q.er.d.Z

?o

,lreerpq +R

I q- q q/

Rqi-s: qq-o3-?oqq
qnTrf,o

Gi. e|qTvrlE eTi+s-d{ q{l-dqrq f{qftdTd.


s{frt_r q_dfl ETa|qrtq
q-fri E{qfr
H*)TIH FEq wfiq {rqBa q-kr.

ffid

Rffiqld !-+*i F
Rol\-qq q|{l
fuqTd

i-ie.

qr

e;r roqq-qq

Qoo

o/- vh qtriT eTrtih dr$ +d-d

frqrfi-dTd mqq'

q' 3rd w+}d

sl.

qs syils'

fr.qT?qffi

y+qT nd-d-dT er{rw.

q_qR

eT-&

e+rt.

ffid qffid M

qsfqF ffiqq

v< Rrqqt} dqTFrs qd

{ilT{ +lqFn <h rfqius

M-*n-a

qT

eTq_s{ +Erqr

ffi

ud-d od-{r

erd mrF.uqrn +d 3Trtd.


rqsrTrTrd

tr",H'-qT

q. FqTr4iET

wi+d sqq. e.

\iyilqfl-qrtsi

#'#H#m:

?.

" ffi*t-t

w-qft-e

frE-d

\.

qd

3r+s frqTrf q-ei-d vilqq |w*Tfr


ft-au-qrs qn

*{a

oTr4rs{

({i_q ditqeTq{ HrqTft

{|dqrrl 3

q' dqilT{
wf cTeT-idr enirf*er

Hil Ht*

eTffi

{s ro 3Trrr*r{ tqrd RTq{ qri

qrqrqql {qilT{ Er-iTqr& qmtd

z' q{-d}, ffi Tirlq+tq q e+-d'eqii

sf,rT f,Fr

qrq

<}-q qqiqT

wi

AsriqRs

en+qr* {rfrd.

s*E q e'*

g-qdqTd

orqq*T Fqrr4tg grrl Hr,,-q {'frf,.

vd ti,vilq* f{srqffl
*rwro tA 61, ;qiq1 silq-dr e1q R)qd
-gF+o
qei s[d-f, qerr+r
ffieT format
R. rs -d* ?o q\ oEo
s_{lril.

"

RId: oitile|q
Fqqifr' RQ-o3-Ro R\

(En'

di. fl.

Rr+)

{idTee'
H-ilsRq-dfi qrulqreq

wm ort4-s4 6

Dr. Babasaheb Ambedkar Marathwada university, Aurangabad- 431 004

Sahakar Maharshi Balasaheb pawar Adhvasan Kendra

for
l.

Full Name of the Candidate


Photo

2.

Date of Birth

J.

Permanent Address with

ContactNumber
4.

Faculty and Subject in which


enrolled for Ph. D. Degree

5.

Research Topic

6.

Caste

7.

Date of Registration for ph. D. :


Degree (Enclose the confirmation
letter)
Do you get any Fellowship/ financial: yes /
No
Assistance for Ph. D. work?
: If yes,

8.

Sex

Which?---f the documents).

Division with
%o

of Marks

10. Any Other Information (please Specify):

I hereby declare that the above information


is true to the best of my knowledge
and belief.
Date:
Signature of the Candidate and

Name
Place:

Signature of Research Guide with Seal

You might also like