NORTH-EASTERN HILL UNIVERSITY Headquarters: Shillong

Form No: .

Bank Draft No. . . (For downloaded form only)

dated ......

For Office use only

1. Category: ST/SC/PH/Gen 2. NEHU Ward: Yes/No ADMITTED / REGRETTED

APPLICATION

FORM
Attach two recent Passport size Color Photo in white background

For General Courses/Other Courses

(M.A/M.Sc/M.Com./MLISc./M.Ed/M.Phil/Ph.D./ Certificate/Diploma Courses) Session: 20.. 20.

Signature of Head of Department

1. Application for admission to ________________________________________ Programme (Shillong/Tura Campus) 2.Name in of the applicant Ms./Mr. (in Block Letters) 3. Nationality : 4. Are you a domicile of Meghalaya? Yes or No (attach evidence) 5. Fathers Name : 6. Mothers Name : 7. Permanent Address : . .. PIN : Telephone No. Mobile No Email 8.Mailing Address : . .. PIN : Telephone No. Mobile No. 9. Date and Place of Birth : Day Month 10. Blood Group (please tick ) : Year Place A 14. 11. . Marital status (please tick ) : Married Unmarried 13. Do you belong to SC/ST ? If yes, Please mention Yes No B AB O +ve -ve 12. Religion : 14. Are you employed? (please tick ) : Yes No GENDER M F

15. Educational qualification (Matriculation onwards) : Examination School/Board/College/ Passed University

Subject

Year

Division

% of Marks

16.If applying under University Special Quota/Physically Challenged, for any P.G. Programme, mention the category. (Attach relevant documentary evidence) 17.Sl.No.17-19 for M.Phil/Ph.D. Candidates only Please indicate, in order of preference, the area in which you would like to pursue research (1)________________________________________ (2) __________________________________________ (3) ________________________________________ (4) ___________________________________________

18.For M.Phil applicants only Do you want to be considered for admission to Ph.D. after the first semester ? .. 19. Have you qualified for (NET-JRF) Please attach a note on a separate sheet, explaining is not more than 200 words why you want to pursue a further programme of study/research in the subject and attach it to the application 20. List of enclosures:

Declaration by the applicant and the guardian

(a) I declare that the entries made above by me in the form are correct to the best of my knowledge. I am aware that if any of the entries is found to be incorrect, my admission is liable to be rejected. (b) I undertake to abide by the rules of the University enforce from time to time and to submit myself to the disciplinary jurisdiction of the Vice-Chancellor and other authorities of the University. (c) I undertake that I shall not involve myself in ragging in any form. In case, I am found to be involved in ragging the University may take any action against me.

 Signature of the Guardian with date

Signature of the Applicant with date

Name of Guardian : .. Address : Relationship to the Applicant: Phone Number : ____________________________________________________________________________________ Important Instructions (Please read the following instructions carefully before filling up the form) i. The form should be complete in every respect ii. The form duly completed in all respects and supported by all documents should be submitted to the concerned department/centre located either at Shillong or at Tura. iii. The form should be accompanied by the following (attested copies): 1. High School/Higher Secondary Certificate in support of date of birth 2. Details of marks at the various examinations 3. No Objection Certificate from employer, if employed 4. Certificate of SC/ST, if applicable 5. Any other documents in support of candidature
Students applying for more than one department should fill in separate application forms.