Application Form for Admission in University Teaching Department
Session : 2022-23

Department and Course
Department*		Course*

Applicant's General Details

First Name *

Last Name *

Father's/Husband Name*

Father's/Husband Occupation*

Mother's Name*

Mother's Occupation*

Guardian Name*

Guardian Address*

Date of Birth*

(dd/mm/yyyy)

Place of Birth*

Mobile*

Category*

Gender*

Nationality*

Whether domicile of Madhya Pradesh* Yes No

Medium*

Sub Category Minority Handicapped JK Migrants JK Residents
Freedom Fighter

Phone

Permanent Address
Address*
State*

Copy To Correspondence Address

Correspondence Address
Address
State

Particulars of the qualifying examination


Exam Passed*	University/Board*

Passing Year*	Percentage*	. %

Academic qualification (From High School/Higher Secondary Onwards)
Graduation/PG/LLB का Result Awaited होने पर पूर्व के सभी Semester/year का Aggregate enter करे.
Class	Roll No	Year	Obtain Marks/ CGPA	Total Marks/ CGPA	Subjects	%	Board/ University	College/School Name	Marksheet No	If Result Awaited
10th*
10+2/ Polytechnic Diploma/ Old 11th
Graduation
PG
LLB
Other

Is there any gap between studies

Do You Have any ATKT/Supplementary Pending in previous semesters/years?*

Other Details
Whether applied for admission to any other course of this university:* Yes No	Course Name*
Whether the applicant is in service:* Yes No	Details*
Whether the applicant's parents are working in this university:* Yes No	Details*
Extra Curricular Activities and Other Certificates (If any)

Have you been vaccinated against covid-19? *
How many doses taken ? *

Other Certificates
240 hrs participation in NSS activities at University level or B/C Certificate	NCC "C" Certificate	Cultural activities at Inter-University level/National level	Sports activities at Inter-University level/National level
Yes No	YesNo	YesNo	YesNo

Enclosures (To be submit in Hard copy in the department)*
Proof for DOB	Marksheet	Migration certificate	Gap Certificate	Caste Certificate	Sub Category Certificate
Required Eligibility Document

Upload Photo with Signature*


Upload Image

(Scan copy in .pdf format and size between 10 KB to 250KB)

(Click browse to upload your High School Marksheet)

(Click browse to upload your Higher Secondary Marksheet)

(Click browse to upload your Caste Certificate)

(Click browse to upload your Graduation/PG Graduation Marksheet as per eligibility)

Declaration*

I declare that the information given above is correct. I have read the admission rules prescribed by the University and shall abide by them and by all the other rules of the University. Further, I am not pursuing any course from BARKATULLAH University or any other University, either regularly or part time or through Distance mode, fetching me any degree. If I do not submit the required caste certificate/ other certificate/ relaxation at the time of admission for getting weightage and if I do not provide the correct information in required column then I will have no objection if I am considered as a general candidate for admission.

सूचना: ऑनलाइन फॉर्म भरने एवं शुल्क भुगतान करने की सुविधा सीधे छात्रों को उपलब्ध कराई गई है। अतः छात्र स्वयं फॉर्म भरें एवं शुल्क का भुगतान करें। किसी अन्य व्यक्ति या इंटरनेट कैफे से किये गए भुगतान हेतु छात्र स्वयं जिम्मेदार होंगे।

Note:- The candidates whose final result is awaited should add total marks and marks obtained of all the earlier Semester/Years and then mention it . ऐसे अभ्यर्थी जिनका अन्तिम परीक्षा परिणाम घोषित नहीं हुआ है वे पूर्व के समस्त सेमेस्टर/वर्षो के पूर्णांक एवं प्राप्तांको का योग उल्लेखित करें।

Application Form for Admission in University Teaching Department Session : 2022-23

Application Form for Admission in University Teaching Department
Session : 2022-23