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Dibrugarh University DURAT Application Form

How to Apply The candidates those who are interested in applying for DURAT 2014 are required to send their applications in the prescribed format on or before 24th October 2014. Application Form State Bank of India Bank Challan The intending candidates shall have to deposit Rs.500.00 (Rupees Five Hundred) + Rs.60.00 (Rupees Sixty)* only as Examination Fee + Bank Charge at the Account of the State Bank of India of mentioned in the prescribed Bank  Challan, which can be tendered through any Branch of the State Bank of India. Prescribed  copies of the Bank Challan are available in the Dibrugarh University web site. It may kindly be noted that the University shall not receive the Fees in any other Form. The filled in Application Form with all requisite testimonials and the University Copy of the Bank Challan is to be submitted at the Teaching Department/ Centre of Studies of the subject concerned by 24.10.2014. The University authorities shall however, not be responsible for non-delivery/late delivery of forms sent by post. Bank Charge revised as Rs.60/- per transaction as per the Bank Requirement.

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Dileep Singh Thakur
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13 views3 pages

Dibrugarh University DURAT Application Form

How to Apply The candidates those who are interested in applying for DURAT 2014 are required to send their applications in the prescribed format on or before 24th October 2014. Application Form State Bank of India Bank Challan The intending candidates shall have to deposit Rs.500.00 (Rupees Five Hundred) + Rs.60.00 (Rupees Sixty)* only as Examination Fee + Bank Charge at the Account of the State Bank of India of mentioned in the prescribed Bank  Challan, which can be tendered through any Branch of the State Bank of India. Prescribed  copies of the Bank Challan are available in the Dibrugarh University web site. It may kindly be noted that the University shall not receive the Fees in any other Form. The filled in Application Form with all requisite testimonials and the University Copy of the Bank Challan is to be submitted at the Teaching Department/ Centre of Studies of the subject concerned by 24.10.2014. The University authorities shall however, not be responsible for non-delivery/late delivery of forms sent by post. Bank Charge revised as Rs.60/- per transaction as per the Bank Requirement.

Uploaded by

Dileep Singh Thakur
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

APPLICATION FORM FOR APPEARING IN THE DIBRUGARH UNIVERSITY RESEARCH

ADMISSION TEST (DURAT) 2014



Sl. No.


DIBRUGARH UNIVERSITY
Dibrugarh 786 004

Subject:
Applied for Please mark X in the appropriate box
[Link] Ph.D. Both


1. Name of the candidate in Full:
(BLOCK LETTERS): Surname Name Middle Name
MR./MS.

2. Address for Correspondence with PIN Code and Mobile No.:
________________________________________________________________________

________________________________________________________________________

Pin___________________________ Mobile No. ___________________

3. Fathers Name :

4. Guardians Name, Occupation and Address:
Name________________________________________Occupation_____________________
Address_____________________________________________________________________
_____________________________________________Pin_____________________
Mobile No./Telephone No (with STD Code) _____________________________________________

5. Mothers Name : ..

6. Date of Birth: Day Month Year
(According to the Certificate)

7. Nationality: ..

8. Sex: (Please tick /) Male Female

9. Caste (Please tick/)
(Attach Certificate)






To be submitted to the concerned Teaching
Department/ Centre of Studies on or before
24.10.2014


Affix passport
size
photograph
here



SC ST(P) ST(H) OBC GENERAL

10. Whether differently abled: Yes No
(If yes, please state the Nature of the Handicap and attach Medical certificate issued by the Joint Director of Health Services of the
District concerned)

11. Whether employed? Yes No (if yes, produce No Objection certificate from the Employer)

12. Educational Qualification (Please attach self attested Pass Certificate and Marksheet):
Post Graduate
Or Equivalent Degree
Subject
University/
Institute
Roll No. Year of
Passing
Class Percentage of
Marks/CGPA




13. Give particulars of submission of Examination Fee:
N.B.: The candidates shall have to deposit Rs.500.00/- (Rupees Five Hundred) + Rs.60/- (Rupees Sixty) only as
Examination Fee+ Bank Charge at the Account of the State Bank of India mentioned in the prescribed
Bank Challan, which can be tendered through any Branch of the State Bank of India. Prescribed copies of
the Bank Challan are available with this Application Form. It may kindly be noted that the University shall
not receive the Fees in any other form.

(a) Fee Deposited Bank Challan No.

(c) Amount: Rs. (d) Date of Issue:



DECLARATION
I declare that the information given above is true and complete to the best of my knowledge and
belief and if any of them is found to be incorrect, my admission shall be liable to be cancelled and I
shall be liable to such other disciplinary action as may be decided upon by the University.


Date:
Place: Signature of the Candidate

Incomplete Application forms shall be summarily rejected.


DIBRUGARH UNIVERSITY RESEARCH ADMISSION TEST (DURAT), 2014

ATTENDANCE SLIP FOR USE AT THE TEST CENTRE

(TO BE KEPT WITH THE OFFICER-IN-CHARGE FOR USE ON THE DAY OF EXAMINATION)

NAME__________________________________ Subject:________________________

Applied for
(Please mark X in the appropriate box)
[Link] Ph.D. Both


Roll No.



Date of Test : 15.11.2014
Time : 11.00- 14 Hours



Signature of the Candidate Signature of the Head/ Director of the Department/ Centre of Studies


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


DIBRUGARH UNIVERSITY RESEARCH ADMISSION TEST (DURAT), 2014
ADMIT CARD

Applied for
(Please mark X in the appropriate box)
[Link] Ph.D. Both


Name of the Candidate____________________________________________

Fathers / Mothers Name___________________________________________

Address for Correspondence _____________________________________
___________________________________________________________
________________________________ PIN

Date of Test : 15.11.2014
Time : 11.00- 14.00 Hours






Signature of the Candidate Signature of the Head/ Director of the Department/ Centre of Studies


*Admit Card shall not be sent by post. The candidates shall have to collect it from the Teaching Department/ Centre of Studies concerned.




Please
Affix
passport
size
photograph
Roll No.


Please
Affix
Passport size
Photograph

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