University of Mumbai

Passport
Size
Photograph

APPLICATION FORM

(Ph. D. Entrance Test)

Faculty Code:-

(Faculty Code: 1 = Arts, 2 = Commerce, 3 = Law, 4 = Science, 5 = Technology)

Subject Code:(Subject Code: Refer Annexure - III)
Name of the Candidate:Surname
First / Own Name
Fathers / Husbands Name
Mothers Name
Gender Code:-

(Gender Code: 1 = Male, 2 = Female)

Category Code:-

(Category Code:- 0 = Open, 1 = SC, 2 = ST, 3 = DTA, 4 = NTB,

5 = NT1, 6 = NT2, 7 = OBC /SBC)

Centre Code:-

(Centre Code:- 0 = Mumbai, 1 = Dadar, 2 = Andheri,

3 = Ghatkopar, 4 = Borivali, 5 = Thane, 6 = Kalyan, 7 = Ratnagiri)

Address for Communications:- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Pin- ------------------- Telephone/ Mobile ----------------------E-Mail ID- ------------------------------------------------------------

Qualifications:Sr.
No.

Diploma/ Degree

Subjects

Board
/University

Year of
passing

% age

Class

Work experience (if any):Sr.

No.

Name of the
Organization

Designation

Year of
Experience

Nature of work

The above information furnished by me is true and correct and in case if the University
finds anything incorrect in my application form the same can be rejected by the University.
Date:
Place:

Signature of the Candidate