University of Pune : Registration for Ph. D.

Entrance Examination

http://unipune.ac.in/phdexam/phdPrintFormCash.aspx

Application Form Number:11030003573

Paste a latest Passport size photograph here with your signature across.

Application Form for Ph.D Entrance Examination - 17 December 2011

Do not staple.

Personal Data: Surname: ZENDE Gender: First Name:

ATUL

Middle Name: PANDHARINATH

Male 30 NARHARI NAGAR GULMOHOR ROAD AHMEDNAGAR , AHMEDNAGAR ,AHMEDNAGAR ,Maharashtra

Mobile: 9422500844

Address for Correspondence: Phone: 02412424381

Pin Code: Email ID:

414003 atul.zende@gmail.com

Physically/Visually Handicapped : Not Applicable

Category :

OPEN

QUALIFICATION DETAILS: Applying without P.G. Degree : No Name of Master's Degree : M.B.A. Passing Year :2006 GPA/Marks obtained in P.G. Degree : 1837 / 2800 Grade : First Class Exempted from appearing for Paper I & II : Yes If Yes, Exam Given : UGC NET Percentage : 65.61 P.G Subject : MANAGEMENT

Application Fee Details: Cash

1 of 3

14-11-2011 21:17

University of Pune : Registration for Ph. D. Entrance Examination

http://unipune.ac.in/phdexam/phdPrintFormCash.aspx

Declaration:
1. I, ATUL PANDHARINATH ZENDE, hereby declare that all statements made in this application are true, complete and correct to

the best of my knowledge and belief and in event of any of the information being found false or candidature is liable to be cancelled and appropriate action will be initiated against me.
2. I have submitted only one application form/Separate application form for different Subjects for this test. 3. I further declare that I fulfill all conditions of eligibility regarding educational qualification prescribed for taking this Ph. D. Entrance

Examination.

I have enclosed the attested copies of certificate(s) of being SC, ST, OBC, SBC, DT/NT, PH/VH (Physically or Visually Handicapped).

As well as the Qualifying Degree Certificate & statement of marks at P.G. Level.

I have noted that if my application is found to be incomplete/ defective/ ineligible, it will be summarily rejected and no correspondence will be entertained in this regard.

Place:

Date:

Please sign inside box

2 of 3

14-11-2011 21:17

University of Pune : Registration for Ph. D. Entrance Examination

http://unipune.ac.in/phdexam/phdPrintFormCash.aspx

Ph.D. Entrance Exam Challan : Bank Copy

BANK OF MAHARASHTRA

This challan is to be accepted at any branch of BANK OF MAHARASHTRA for credit to University of Pune account No 60078206551 through Fee Collecon Menu ----> UOP fee collecon only in cash or by transfer cheque. University copy and applicants copy of challan is to be handed over to applicant aer embossing banks stamp.

Application/Challan No:11030003573
Name and Address of Applicant ATUL ZENDE 30 NARHARI NAGAR GULMOHOR ROAD AHMEDNAGAR , AHMEDNAGAR Mode of payment: CASH Only

C/D C/C A/C No: 60078206551 Name of A/C Holder: Registrar University of Pune, Pune-7 Total Amount : Rs.800 Rs.(in Words): Eight Hundred Only

Revd.By

Deposited By
Ph.D. Entrance Exam Challan : University Copy

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Cut here - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

BANK OF MAHARASHTRA

Application/Challan No: 11030003573

Name and Address of Applicant ATUL ZENDE 30 NARHARI NAGAR GULMOHOR ROAD AHMEDNAGAR, AHMEDNAGAR Total Amount : Rs.800 Rs.(in Words): Eight Hundred Only

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -Cut here - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Ph.D. Entrance Exam Challan : Applicant Copy

BANK OF MAHARASHTRA

Application/Challan No: 11030003573

Name and Address of Applicant ATUL ZENDE 30 NARHARI NAGAR GULMOHOR ROAD AHMEDNAGAR, AHMEDNAGAR Total Amount

Rs.800

Rs.(in Words): Eight Hundred Only

Print This Form

3 of 3

14-11-2011 21:17