UNIVERSITY OF PUNE

Form of Application for Admission to Post-Graduate One Year

Interdisciplinary Certificate Course in Women's Studies
[N.B. : All forms should be sent to the Director, Krantijyoti Savitribai Phule Women's
Studies Centre, University of Pune, Pune 411 007]
To,
The Registrar,
University of Pune,
Pune 411 007
Sir/Madam
I request that I may be admitted as a student to the P.G. Certificate Course in
Women's Studies at the Krantijyoti Savitribai Phule Women's Studies Centre.
I hereby give the undertaking that I shall not request for any special concession
such as a change in time or day fixed for the University examination on religious or any
other grounds.
Thanking you,
Yours faithfully,

Date :

( Signature of Applicant)

(Information about the Student)

Name of the candidate: _______________________________________________________
(BLOCK CAPITAL
SURNAME
NAME
FATHER'S NAME
MOTHERS NAME
LETTERS ONLY)
Name of the candidate: _______________________________________________________
(For married female candidate)

2. Address in Pune

Phone No.
3. Permanent Address

Phone No.

SURNAME

NAME

HUSBANDS NAME

: ..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
: .....................................Email address : ...................................
: ..................................................................................................
..................................................................................................
..................................................................................................
: ..................................................................................................

4. Nationality : ...................... 5. Male or Female:...............6. Date of Birth: ...................

7. Backward or Non-Backward Specify Category : ............................................................
SC, ST, DTNT, OBC, Physically Handicap.
(P.T.O)

8. Particulars of Bacherlor's Degree Exam. : (Please attach a true copy of the Marksheet/
Passing Certificate)
University : ......................................................................................................................
College

: ......................................................................................................................

Seat No. : .......................................

Year of Passing : ........................................

Subjects offered : .............................

Marks obtained Total/Out of : ...................

9. What specific interests

: Feminist Theory

do you have in the

Women and Work

area of Women's Studies ?

Women and Agriculture

Women and Media
Violence against Women
Women's Literature and Art
Women and Politics
Any other areas (Please Specify)

10. Medium of Instruction

: Marathi/ English
preferred
11. Any other information
:
such as membership of
professional organization
of NGOs, and hobbies
Work or research experience,
if any, etc.
Signature of Applicant
Admission Certificate
Certified that Smt./Shri .............................................................................................
has been / has not been admitted to the P.G. Certificate Course in Women Studies.
Director
Krantijyoti Savitribai Phule
Women' Studies Centre
Univiersity of Pune, Pune 411 007

Date :
Sr.No.
1.
2.
3.
4.
5.

Application Fee Details:

Amount of Bank Challan/DD
Challan/DD No.
Name of the Bank
Name of the Branch
Date of Challan/DD