Phone: 03228-252222 PANSKURA BANAMALI COLLEGE (AUTONOMOUS COLLEGE : 2018-2019 to 2027-2028) Largest Rural Based, NAAC Re-accredited ‘A’ Grade (2016-2021) DST-FIST (Govt. of India), BOOST-DBT (Govt. of West Bengal) sponsored College Website : E-mail : P.O. - PANSKURA R.S. : PIN 721152 : DIST. - PURBA MEDINIPUR : WEST BENGAL : INDIA – Application Form for Ph.D. Programme in Science: 2017-18 Subject applied for Ph D. Programme ………… …………… …………………………. 1. Name (in block letters) : 2. Name : Father’s /Spouse’s 3. Name : Mother’s Statement of Marks obtained at different examinations : 4. Name of the Board/Council/ Subject(s) Year of Percentage Div./ of Marks / Class Examination University Passing CGPA /Grade Madhyamik or Equivalent H.S . or Equivalent B.A./B.Sc. Hons in ………….. M.Sc. in ……………….. NET/SET/GATE 5. Date of Birth : ( with supporting document) 6. Permanent Address : ( with PIN code) 7. Whether Gen/SC/ ST/OBC-A/ OBC-B : ( with supporting document)
Phone: 03228-252222 PANSKURA BANAMALI COLLEGE (AUTONOMOUS COLLEGE : 2018-2019 to 2027-2028) Largest Rural Based, NAAC Re-accredited ‘A’ Grade (2016-2021) DST-FIST (Govt. of India), BOOST-DBT (Govt. of West Bengal) sponsored College Website : E-mail : P.O. - PANSKURA R.S. : PIN – 721152 : DIST. - PURBA MEDINIPUR : WEST BENGAL : INDIA Application Form for Ph.D. Programme in Science: 2017-18 Subject applied for Ph D. Programme ………… …………… …………………………. 1. Name (in block letters) : 2. Father’s /Spouse’s Name : 3. Mother’s Name : 4. Statement of Marks obtained at different examinations : Name of the Board/Council/ Subject(s) Year of Percentage Div./ Examination University Passing of Marks / CGPA Class /Grade Madhyamik or Equivalent H.S . or Equivalent B.A./B.Sc. Hons in ………….. M.Sc. in ……………….. NET/SET/GATE 5. Date of Birth : ( with supporting document) 6. Permanent Address : ( with PIN code) 7. Whether Gen/SC/ ST/OBC-A/ OBC-B : ( with supporting document)
Ph.%20D.%20Application%20Form,%202018.docx