You are on page 1of 4

Serial No. :____________ M.Sc ( 50 Rs.

SAURASHTRA UNIVERSITY
DEPARTMENT OF BIOSCIENCES RAJKOT-360005

M.Phil
Ph.D.

75 Rs.
500 Rs.

ADMISSION FORM Application for Admission to the First Semester M.Sc. course in Animal Science/ Plant Science/ Biotechnology/ Microbiology/M.Phil/Ph.D. for the year 200 -200 N.B. : 1. The last date for receipt of the duly completed application is_________ 2. Date and Time of Personal Interview will be informed to the Candidate. 3. Separate applications are needed for admission to each of the streams. FOR OFFICE USE ONLY (1) University : - Saurashtra University : Please affix latest - Other University of Gujarat : Passport size - Out State University : attested (2) Year of Passing B.Sc. : photograph (3) Subject(s) : (4) % of Marks : (5) Category Stream : Botany : Zoology : Microbiology : Biotelchnology : Degree programme M.Sc., M.Phil , Ph.D. :

Surname

First Name

Second Name

1. Name in full :_________________________________________________________________ ( in Block Letters) 2. Address :__________________________________________________________________ __________________________________________________________________ Pin code No.:___________________ Phone :_____________________________ 3. Date of birth Place of Birth : 4. Nationality 5. Sex : : Indian Male Foreign Female : Age :

Rs. T.) .6. Please attached a certificate from Civil Surgeon.F.)?________________ If yes. SEBC Socially & Educationally Backward Class.Y. Are you engaged in any part/full time service (Yes/No. since when :______________________________________________ Present status / course :__________________________________________ Name of organization / Institution :_________________________________ Year of Passing Subject offered Marks in % Obtained Class Obtained 9. M.____________________(Approx.Y. Academic Qualification : Examination University . 7. 4. PH-Physically Handicapped and Others (General Category) Tick-the appropriate in No. Guardian's / Father's details : Name :__________________________________________________________ Address :________________________________________________________ Pin code No. (Please attach copies of supporting certificates. If you are Physical Handicapped. Category SC ST SEBC PH OTHER Submit certificate from competent authority for reserved category. 5 and 6.Sc.) 8. S/Y. SC Scheduled Caste.:_______________________ Phone/ Mobile No.____________ Relationship :_____________________________________________________ Annual income of the guardian / Self . ST-Scheduled Tribe.

& Date :______________________________________ Provision Eligibility Certificate No. will cancel my admission. whenever found. if granted.:____________________________________________________ Admitted / Not admitted :_____________________________________________ Fees Paid & Receipt No. I also undertake to observe the discipline and obey the authorities and also rules and regulations time to time declare without any notice. & Date :_____________________________ Teacher in Charge Head of the Department . if any. Date :____________________ Place :____________________ Signature of applicant (No other than applicant should sign here ) FOR THE OFFICE USE ONLY Received by Checked by :__________________________________________________ :__________________________________________________ Registration No.DECLARATION I hereby declare that the information given herein is correct and that misstatement.

C. you will have to pay the prescribed fees immediately. If admitted. Su/Bio /______ Date :______________ Name in Full (In Block Letters) And Address for Communication) Please affix latest Passport Size photograph 3. Please bring this letter with you at the time of Admission Interview. STREAM : Botany Zoology Microbiology Biotechnology You are requested to appear for a personal interview for admission on_______________________________ At 1100 hour at this Department without fail. . Otherwise you will not be considered thereafter for the admission You will bring all your original marksheets and certificates at the time of interview.P. No.______________ To be filled by the candidate : Saurashtra University Department of Biosciences Rajkot U.Sr.