Application Form No…….................

ICAR- INDIAN VETERINARY RESEARCH INSTITUTE (Deemed to be University)

Izatnagar-243 122, Bareilly (UP) India

ADMISSION TO PhD DEGREE PROGRAMMES FOR 2018-2019 (Note: Please read information Bulletin carefully before filling the application form and use correct code)

Roll No…….......……. Examination Centre ....................

(Roll No. and Examination Centre will be filled by the Office only)

Discipline Name ....................................................... Discipline Code .......................... 1. PhD Degree Programme (Session).....….......…..............Subject Code**……………......…..

Affix recent photograph with signature of the

candidate

2. Category of Admission: ..................................................................................................................................

i.e. Open or Sponsored by ICAR Institute, Central/ State Agricultural Universities, Central/State Government Departments 3. Full name of candidate in capital letters: (first, middle and surname): 4. Father's name:

5. (i) Mother's Name:............................................... (ii) Husband's Name: ................................................. (in case of married women)

6. Date of Birth Age (as on 01.08.2018) ...................... (only completed years)

7. (i) Category Whether General/OBC/Divyang/SC/ST…... (ii) Nationality:.................................. 8. (i) Sex: Male/Female: ........................................... (ii) Marital Status: Married/Unmarried:...................... 9. (i) State/Union Territory of domicile: ......................... (ii) Rural/Urban: ...........................

10. Nearest Railway Station to Home town: ................................................................................................... (can not be changed during study period)

11. Choice of Examination Centre: .................................................................................................................. (Izatnagar- 01, Bengaluru- 02, Kokata- 03, Palampur- 04, Pune-05, National Institute of High Security Animal Disease, Bhopal- 06)

12. Educational Qualifications:

Particulars Name of Examination

High School Intermediate BVSc & AH MVSc

or equivalent or equivalent

(a) University/Board

(b) Institution/College (c) Year of passing the exam. (d) Prescribed minimum duration of course in years

(e) Medium of instruction (f) Division/Class/ OGPA obtained

(g) Maximum Marks/Overall Grade Point attainable

(h) Percentage of marks obtained (upto one decimal place)

(i) Subjects taken (j) Date of final Viva-Voce in M.V.Sc. (k) M.V.Sc. Thesis Title: N.B.: Strike-off which is not applicable * For Sponsored candidates only ** Indicate one code out of the subject given in the Information Bulletin

13. Full Address for Correspondence:

P I N

14. Permanent Home Address :

P I N

15. Whether employed: Yes / No. (i) If employed, give full Name, Address and Contact No. of employer

...... ..... ..... .... ..... ..... .... ..... ..... .... ..... ..... ...

.................................................................................................................................................... 16. Candidate Aadhaar No …………………………….. Mobile No. : ...........................

Telephone No with STD Code. …………………………….. E.mail: ..…………………….…… 17. Language Known (Read/Write/Speak) :…………………………. 18. Employment Record :

Name of Institute/ Post held Temporary/ Scale of pay Date of Date of Dept./University/ Permanent joining leaving Organisation

19. Are you a recipient of any Scholarship/Fellowship from the ICAR/CSIR/UGC/Govt. of India for Ph.D./M.V.Sc. Degree ? ……………. Yes / No. If yes, please attach an attested copy of the letter indicating the same and the period upto which it is valid.

20. (a) Were you admitted at I.V.R.I. earlier ? ..................... Yes / No

(b) If so, state the programme and year : Programme ......................................... Year .................... (c) State if you discontinued the programme : Yes / No (d) If yes, state the date from which discontinued and reasons thereof : ............................................. (e) Whether the amount of bond money deposited ? ............................ Yes / No (f) If no, the bond money/fellowship paid to him/her, has to be refunded before admission

21. Fees: E-receipt: SBI Collect Reference No.: ...................................................................................

Dated ...................................... Amount ..............................................................................

DECLARATION BY THE CANDIDATE

I, the undersigned hereby declare that information furnished by me is correct and that no relevant information has been suppressed. I also declare that if any information or document furnished by me in this application is found to be wrong, I shall have no objection to my selection being cancelled outrightly. (a) I am not employed and, therefore, submitting this application directly. (b) I am an employee of the …………………………………......................................……. and, therefore,

submitting my application through proper channel, as a sponsored candidate. (c) I am an employee of ........................... & applying under Open Category and submit NOC later on. (d) If admitted, I undertake to abide by the rules and regulations of the Institute. (e) I have enclosed attested photo copies of all the required certificates and documents.

Place:………………………. Date:………………….........

(Signature of the Candidate)

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FOR SPONSORED CANDIDATE

Application forwarded for consideration under SPONSORED CATEGORY. He/She has (in words) ………........………………. years of experience in Teaching/Research/Extension at this Organisation. In the event of his/her selection, he/she will be relieved so as to enable him/her to join at IVRI on 01.08.2018.

The candidate will be fully sponsored on Deputation terms/Study leave entitling him/her for salary and allowances.

Date: ..................

(Signature of the Sponsoring Authority) Seal Note: No Scholarship/Fellowship will be granted to the sponsored candidates.

(For Office use only)

Index No............................. E-receipt: SBI Collect Reference No.: ............................................................ Dated .............................................. Amount ...............................................

Checked by

INSTRUCTIONS FOR CANDIDATES TO FILLUP THE APPLICATION FORM

FOR ADMISSION TO Ph.D. PROGRAMMES 1. The candidate should carefully go through the Information Bulletin before filling-up the application

form. 2. The application form should be filled legibly in candidate's own handwriting without any cutting/

overwriting/erasing, etc. 3. The candidate should ensure that he/she fulfills all the eligibility requirements for appearing in the

entrance examination before filling-up the application form. 4. Admit Cards will not be sent by post. Candidates have to retain a copy of Admit card with them and

noted down the Roll No. as displayed on website. The List of Students along with Roll No. will be displayed on Institute's website (www.ivri.nic.in).

5. No candidate will be allowed to appear in the entrance examination without Admit Card. 6. First semester of Academic Session will commence on 01.08.2018.

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ICAR- INDIAN VETERINARY RESEARCH INSTITUTE

(Deemed University)

Izatnagar- 243 122, Bareilly (UP) India

ADMISSION TO PhD DEGREE PROGRAMME FOR 2018-2019

VERIFICATION SHEET

Affix recent

photograph with signature of the

candidate Roll No…..............……….

(to be filled by Office) Full name of candidate in capital letters: (first, middle and surname): Father's name: PhD Degree Programme ............………………………… Examination Subject Code …........….......…………….

Signature of Candidate

The above candidate has been permitted to appear in the written entrance examination for admission to Ph.D. degree programmes 2018-2019. (FOR OFFICE USE ONLY)

EXAMINATION SCHEDULE

Date & Time of Written Exam Signature of the Signature of the Candidate Invigilator

6th May, 2018 (Sunday) (11:00 a.m. to 1:00 p.m.)

Centres for written Examination: IVRI Izatnagar, Bengaluru, Kolkata, Pune, Palampur, NISHAD Bhopal. Interview Schedule: 11th June, 2018 to 22nd June, 2018. Note: The venue of the interview will be IVRI, Izatnagar. The exact date and time of the interview in respect of successful candidates in the written examination will be displayed on the website of IVRI while declaring the result of written entrance examination. N.B.: The Invigilator should check the photograph of the candidate and obtain his/her signature. If the

candidate is not present, the word 'ABSENT' should be recorded and signed by the Invigilator.

REGISTRAR

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ICAR- INDIAN VETERINARY RESEARCH INSTITUTE (Deemed University)

Izatnagar- 243 122, Bareilly (U.P.) India ADMISSION TO PhD DEGREE PROGRAMME Affix recent FOR 2018-2019 photograph with

signature of the Sl.No. _______ OFFICE COPY candidate (For office use only)

ADMIT CARD (To be filled-in by the Candidate)

Roll No……...........…….

1. Name: ................................................................................................................................................. 2. Programme: PhD .......................................................................... 3. Discipline: ............................................................................................................................................ 4. Date of Entrance Examination: 6th May, 2018 (Sunday) 5. Examination Centre for written examination: ................................................................................................. Interview Schedule: 11th June, 2018 to 22nd June, 2018. Note: The venue of the interview will be IVRI, Izatnagar. The exact date and time of the interview in respect of successful candidates in the written examination will be displayed on the website of IVRI while declaring the result of written entrance examination. Signature of Candidate Registrar Instructions 1. You must report at the examination centre atleast 30 minutes before the commencement of the examination. 2. Show your admit card to Supervisory Staff otherwise you will not be allowed to appear in the exam. 3. Use of unfair means will disqualify you from the examination.

ICAR- INDIAN VETERINARY RESEARCH INSTITUTE (Deemed University)

Izatnagar- 243 122, Bareilly (U.P.) India

ADMISSION TO PhD DEGREE PROGRAMME FOR 2018-2019

Sl.No. _______ CANDIDATE COPY

(To be retained by the candidate and produced at the time of examination) ADMIT CARD

Affix recent photograph with signature of the

candidate

(To be filled-in by the Candidate)

Roll No……...........…….

1. Name: ................................................................................................................................................. 2. Programme: PhD .......................................................................... 3. Discipline: ............................................................................................................................................ 4. Date of Entrance Examination: 6th May, 2018 (Sunday) 5. Examination Centre for written examination: ................................................................................................. Interview Schedule: 11th June, 2018 to 22nd June, 2018. Note: The venue of the interview will be IVRI, Izatnagar. The exact date and time of the interview in respect of successful candidates in the written examination will be displayed on the website of IVRI while declaring the result of written entrance examination. Signature of Candidate Registrar Instructions 1. You must report at the examination centre atleast 30 minutes before the commencement of the examination. 2. Show your admit card to Supervisory Staff otherwise you will not be allowed to appear in the exam. 3. Use of unfair means will disqualify you from the examination.

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