Sardar Patel University of Police, Security and Criminal Justice

Mathania Road, Daijer, Jodhpur - 342304 (Raj)

Ph. No.: 0291-3062029, 3062035, 3062030 Fax: 3062036, E-mail: registrar@policeuniversity.ac.in
Part Time* / Full Time Ph.D. APPLICATION FORM
Details of fees payment: Rs………..….…. DD No. …………..…………
Name of Bank: …………………….…….. Date: ……………………. Affix Latest
Ph.D. Programme applied for in the field of: - Photograph
Faculty …………………………………. ……………………….

Subject …………………………………. ……………………….

I. PERSONALS DETAILS OF THE CANDIDATE
1. Name of the Applicant:
(As per mark-sheet in Block Letters) …………………………...……………………………………………

2. Father’s Name: ………………………………………………………………………………….

3. Mother's Name: ………………………………………………………………………………….
4. Date of Birth (DD/MM/YY): ………………...… 5. Gender (M/F) ………………………………
6. Address (in English) ……………………………………………………………………………
……………………………………………………………………………………………………..
……………………………………… District …………………… Pin Code: …………………..
7. Mobile No. (I) ………………………………. (II) ……………………………………………
8. E-mail: ……………………………………….. 9. Aadhar No.: ………………………………
10. Category: (GEN/OBC/SC/ST) ………………….. 11. Minority (Yes / No) ………………….
12. *Serving Professionals from Police, CISF, BSF, Paramilitary and related domains with
minimum 10 years of service: Tick Yes / No  If Yes Designation ………………..…………….
II. ACADEMIC ACHIEVEMENTS (Attach Self attested copy of Marksheet)
S. % of Marks &
Name of Degree & Year of Passing University / Board Subject
No. Division
1 Secondary
2 Sr. Secondary
3 Graduation …............………………….....
4 Post-Graduation …………………………..
5 Additional Qualification ………………….
6 Other …………………………………

III. Whether Qualified in UGC NET / SLET: ………………... If yes, (Enclosed copy of Pass Certificate)
DECLARATION
I hereby declare that I have carefully read the instructions and that the entries made in this application form are correct to the best of my
knowledge and belief. If selected for admission, I promise to abide by the rules and discipline of the University.
I note that I fulfill all qualification which is necessary for Ph.D. as per notification the decision of the University shall be final in regard to
selection for admission and assignment to a particular Department and field of study. The University shall have the right to cancel my admission
at any time after my admission, provided it is satisfied that I was admitted on false particulars furnished by me or my antecedents prove that my
continuance in the University is not desirable. I agree that I shall abide by the decision of the University, which shall be final.

Place …………………. Date …………………..

Signature of the candidate
List of Enclosure: - Tick all that apply
1. Demand Draft ( ) 2. Self Attested Copy of Aadhar Card( ) 3. Self Attested copy of all mark sheets/grade cards ( )
4. Self Attested copy of UGC/NET/SLET etc. ( ) 5. Self Attested copy of Caste Certificate ( )