SHRI VISHWAKARMA SKILL UNIVERSITY
(State University enacted under the Government of Haryana Act 25, 2016)
Admission Form for PhD. Session: -2020-21
University Registration No______________________________________________
(For Official Purpose)
Name of the Programme: ………………………………………………………………………………….
Recent Coloured
Tick the Skill Faculty:1) Skill Faculty of Engineering and Technology Photo
2) Skill Faculty of Management studies and research
3) Skill Faculty of Applied Science and Humanities
1.Name of the Candidate: Mr./Ms.____________________________________________________
(As per Matriculation certificate) in Capital letters
2.Father’s Name: Sh.________________________ 3. Mother’s Name: Smt.___________________
(As per Matriculation certificate) in Capital letter (As per Matriculation certificate) in Capital letters
4.Date of Birth: ___ /___ /_______ 5. Gender: Male/Female __________________
6.Father Occupation________________ 7. Family Income_________________________
8.Nationality: _________________ 9. Religion: ________________________________
10. Aadhaar No (Desirable):_______________ 11. Person with Disabilities (DA/PwD)(Yes/No):___________
12.Domicile: -Haryana /Other State Admission Category: __________ (Gen./BC-A/BC-B/SC/ST/EWS)
(HARYANA)/AIC/J&K migrant/Dudhola domicile
13.Belongs to any minority category (Yes/No) ______ (If yes, please specify):__________________
14.Qualifying examination passed (Details of examination):___________ From (Haryana/Other state)__________
District:_______________ Year of pass________
15. Blood Group___________________ 16. Urban/Rural__________________________
17. Permanent Address: 18.Correspondence Address:
House No: _______________________________ House No: _________________________________
Gali/Mohalla/Colony: _______________________ Gali/Mohalla/Colony: ________________________
City/Village: ______________Tehsil: __________ City/Village: _______________Tehsil: ___________
District: _______________State: ______________ District: _______________State: ________________
Pin Code: _______________ Pin Code: _______________ ____________
Email: _________________________________ Email: ______________________________________
Alternate email: __________________________ Alternate email: _____________________________
Contact No: ______________________________ Contact No: ________________________________
Mobile No: _____________________________ Mobile No: _________________________________
19. Phone No./Contact No. of Father /Local Guardian ___________________________________
Shri Vishwakarma Skill University 1
20.Qualification Details:
Sr. Examination Board/ Stream Passing Subject/Trade/Specialization % of Marks/
No. University (Year & Grade/CGPA
Month)
01 10th
02 10+2
03 Graduation
04 Post-
Graduation
05 Other
21. DD. No. ___________________ Branch Code: __________________ Amount: ____________
Name of the Bank: _________________________ Date of DD: _______________________
22. Information of UGC NET/JRF/CSIR/Teacher Fellowship/ SLET/GATE:
S.No. Discipline: Years of Examination Score Percentile AIR (All India Validity
Bank)
23. Experience, if any,
Name of Address of Designation From To Nature of Salary
Employer
Work Draw (In INR)
24. Undertaking by the Candidate
I ………………………………………………………… hereby declare that all the information furnished in this form is true to the best of my
knowledge and belief. I understand that my admission is liable to be cancelled by the University if any above information is found
incorrect or misleading at any stage.
Signature of the Candidate
Date & Place: Name: __________________________
Shri Vishwakarma Skill University 2
