NORTH-EASTERN HILL UNIVERSITY
Headquarters: Shillong
Form No: …………………. Bank Draft No. ……. ……………………. dated ……………......
(For downloaded form only)
APPLICATION FORM
For General Courses/Other Courses
(M.A / M.Sc / M.Com. / MLISc. / M.Ed / M.Phil / Ph.D. / Certificate / Diploma Courses)
Session: 20…….. – 20……….
For Office use only Attach two recent
Passport size Color
1. Category: ST/SC/PH/Gen Photo in white
2. NEHU Ward: Yes/No background
ADMITTED / REGRETTED
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)
GENDER
M F
3. Nationality :
4. Are you a domicile of Meghalaya? ‘Yes’ or ‘No’ (attach evidence)
5. Father’s Name :
6. Mother’s 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 Year Place
10. Blood Group (please tick
) :
A B AB O +ve -ve
14. 11. . Marital status (please tick
) :
Married Unmarried
12. Religion :
13. Do you belong to SC/ST ? If yes, Please mention
Yes No
14. Are you employed? (please tick
) :
Yes No
15. Educational qualification (Matriculation onwards) :
Examination
Passed
School/Board/College/
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.