BIDHAN CHANDRA KRISHI VISWAVIDYALAYA

Sl.No.Received requiredfees for applicationBIDHAN CHANDRA KRISHI VISWAVIDYALAYAP.O.KRISHI VISWAVIDYALAYA, DIST.NADIA, WEST BENGAL, PIN-741252.Signature(To be filled up by the candidate by his own handwriting)Application Form for Admission to Ph.D.Course in……………………………………………………..under the Faculty of …………………………….for the Session……………………………..Photograph1. a) Name of the Candidate(in Block letters):________________________________________________b) Father’s Name :_______________________________________________c) Mother’s Name :_______________________________________________d) Date of Birth :_______________________________________________e) Sex :_____________________f) Permanent Address :g) Address for Communication :h) Blood group :i) State of Domicile :j) Whether SC/ST :(Contd.P/2)

22. Examination Passed:Degree/ExamInstt. / Univ Year Duration(Yrs.)OGPA/ % age.Class/ Div.Subjects3 .The attested photocopies of admit card (for age verification) certificates and mark-sheets ofall examinations passed should be enclosed in cm 33 cm x 22 cm size paper.4. Employment Particulars (if any):(a) Name of the Employer: ____________________________________________________(b) Post held__________________________ (c) Pay Scale__________________________(d) Whether permitted leave: Yes/No; (e) Period: From _____________to_______________5 Details of Ph.D. Course applied: _____________________________________________a) Subject (Department):___________________________________________________b) Under which Faculty: ____________________________________Signature of the CandidateFor Office Use onlyACCEPTED/REJECTEDSignature of the Members of the Admission Committee