Application Form for Ph.D. Admission

Program Details user
user
Academic Session 2023-2024
Programme/Course Type Professional
Name of Programme/Course Ph.D.
Ph.D Type
Subject Ph.D. Education-Special Education
Department
Student Details
First Name AMIT
Middle Name KUMAR
Last Name KUSHWAHA
Date of Birth 01/07/1988
E-mail ID amit4333u@gmail.com Mobile Number 9336718313
Father's Name RAM MILAN KUSHWAHA Mother's Name RAMA SATI DEVI
Research Guide (To be allotted by the Department)
Local Guardian Mobile 7897040634
 
Personal Information
Domicile UTTAR PRADESH
Gender MALE
Category OBC Certificate Number 583233013029
Religion Hindu Marital Status MARRIED
Blood Group A+ Nationality INDIAN
DSMNRU Employee NO
DSMNRU Employee Ward NO
Disability YES Disability Category LOCOMOTOR DISABILITY-LD
Percentage of Disability 55
Aadhar Card Number 416808081869
Address Details
Permanent Address
Address VILL AND POST- CHERO, NEAR KENDRIYA VIDALAYA District Deoria
Police Station SALEMPUR Nearest Railway Station SALEMPUR
Country India State/Union Territory Uttar Pradesh
PIN Code 274509
Correspondence
Address HOUSE NO.- 87 LALITAPURAM COLONY, RAJENDRA NAGAR EAST District Gorakhpur
Police Station GORAKHNATH Nearest Railway Station GORAKHPUR
Country India State/Union Territory Uttar Pradesh
PIN Code 273015
 
Educational Qualification from 10th Std. Onwards
Name of Exam* Board / university* Passing Year* Mark Type* Total Marks / CGPA* Marks/CGPA Obtained* Equivalent Percentage* Subjects Certificate Number Attach Document
10th or Equivalent UP BOARD 2003 Marks 600 363 60.5 SCIENCE 1976911 View Marks Sheets Doc
10+2th or Equivalent UP BOARD 2005 Marks 500 308 61.6 PCM 817640 View Marks Sheets Doc
Graduation DDU GORAKHPUR UNIVERSITY GORAKHPUR 2008 Marks 1800 895 49.72 DEFENCE STUDIES PO. SCIENCE HISTORY 1001114146 View Marks Sheets Doc
Post Graduation DDU GORAKHPUR UNIVERSITY GORAKHPUR 2013 Marks 1000 526 52.6 POL SCIENCE 6340010029 View Marks Sheets Doc
Other DSMRU LUCKNOW 2014 Marks 1800 1315 73.06 B.ED SE VI RELATES SUB 022 View Marks Sheets Doc
Other DSMNRU LUCKNOW 2018 Marks 2000 1249 62.45 M.ED SE VI RELATED SUB 03 View Marks Sheets Doc
NET Score Card Details
SN# Level of Category Roll No. Year and Month Agency conducting the test Score Attached Document
1 NA
Are you having any Fellowship/Scholarship?:
 

Payment Details : PAID
TRANSACTION ID pay_MR3hl3cqK7Toqu
PAID AMOUNT 750
TXN DATE 17-08-2023
TXN STATUS SUCCESS
DECLARATION

I do hereby, solemn and affirm that details provided by me in this application form under various heads are true & correct to the best of my knowledge and information. I affirm that no part of information has been concealed, fabricated or manipulated and that I have read university’s regulations for eligibility & admission procedure. In the event that information provided by me is found incorrect, inappropriate, false, manipulated or fabricated, the university shall have right to withdraw admission provided to me through this application and to take such legal action against me as may be warranted by law.

I also acknowledge hereby that I have read general instructions for application, procedure of admission, general code of conduct, hostel rules, examination rules, anti-ragging guidelines issued by UGC or Dr. Shakuntala Misra National Rehabilitation University and that I shall abide by them at all points of time. If my involvement in activities relating to discipline in university is found evident, university shall have all rights to take appropriate action against me. I also acknowledge that I am not suffering from any contagious disease that poses potential threat to health and safety of students of the university and shall always treat students with special needs (differently-abled), girls students and economically/ socially deprived with compassion and cooperation.

I Agree

Download and print the application form

 
Uploaded Domicile
 
Caste Certificate
 
Disability Certificate




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