NATIONAL LAW SCHOOL OF INDIA UNIVERSITY NAGARBHAVI, BANGALORE- 560 242 (Old Pin 560 072) Tel. No. +91 80 23160531, 2316 0532, 2316 0533; Tel. Fax: +91 80 23160534 / 23160531 APPLICATION FOR ADMISSION TO INTEGRATED PH.D. PROGRAMME IN PUBLIC POLICY 2019 Photograph (Passport Size) Before filling the application form, please read the general instructions carefully on page 6 of the application form. 1. Name (in Capital Letters as entered in School Certificate ) SEX Eligibility check for Integrated Ph.D. application: Per cent of marks obtained in the master s degree Am I exempted from the entrance examination for Ph.D. admission? We need to ask two questions here: Do you have an M.Phil. degree? Yes / No. If yes, upload your M.Phil. degree certificate. Have you qualified for UGC-NET examination? Yes/No. If yes, upload your NET certificate. 2. Preferred Centre to take Policy Aptitude Test (circle one centre where you want to take the test; Read item 2 on page 6): Bangalore / Delhi / Kolkata / Mumbai / Guwahati 3. Date of Birth DD MM YYYY 4. Place of Birth 5. Nationality 6. Whether you SC belong to Indian (Enclose ST certificate) OBC NRI/Foreign National 7. Residential Status 8. Physically Challenged (Enclose Certificate) Rural Urban Yes No 1
9. Official Address (if employed) (BLOCK LETTERS) State:--------------------------------- Pin Code:-------------------- Telephone No. with (STD) Code: Mobile: E-mail: 10. Residential Address (BLOCK LETTERS) State:--------------------------------- Pin Code:-------------------- Telephone No. with (STD) Code: Mobile : E-mail : Please indicate the address for communication : OFFICIAL (including the E-mail) RESIDENTIAL 11. Academic Qualification/s: (starting from Class 10 education) Detail(s) of Education Year of Passing University / Board Percentage of marks or grade obtained Annexures Please enclose self-attested photocopies of the certificates of educational qualifications, and mark the copy with an annexure number in the last column. 2
12. Employment History Name of Employer / Profession / Institution Designation From To Specific Responsibility Annexures Please enclose copy of the appointment order or experience certificate provided by the employer. Mark the annexure numbers on these copies as continuation of item number 11 and enter the respective number in the last column. 3
13. Engagement with public Issues (Write in not more than 200 words about your engagement with any of the Public Issues) 4
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14. Statement of Purpose (Write in not more than 200 words as to why you want to pursue Integrated Ph.D. in Public Policy at NLSIU, Bangalore ) 6
15. Application Fee This application should be accompanied by Demand Draft of Rs.1,000 (One Thousand Rupees only) towards application processing fee. This is non-refundable. The details of the Demand Draft are to be entered below. We regret that no other modes of payment towards application fee are possible. Application fee for Foreign Nationals is USD 150. Details of the application fee paid: Name of Bank Demand Draft Number / NEFT transfer details Demand Draft / NEFT transfer Date Amount Roll No. of the student I hereby undertake to abide by the Regulations and Rules prescribed by the University from time to time. Date: Place: Signature of the Applicant 7
Instructions to fill the application form for the admission to Integrated Ph.D. in Public Policy 1. You need two passport size photographs. One is to be affixed on page 1 and another for Admit Card for Policy Aptitude Test. 2. For the information on belonging to special categories (no. 6 and No. 8) you need to submit certified copies by competent authorities. 3. Address (item 9 & 10): Specify the address for communication Admit Card will be sent to your email only. 4. For item 11 where information is provided for educational qualifications, make reference to annexures (the photocopies of the certificates) which are numbered in order and attached with the application form. If degree certificate is not issued by the University, a provisional certificate is to be attached. If not, mark sheets for all the years should be submitted. 5. For item 12 where information on employment history is provided, please number the annexures (the offer letter of employment or experience certificate as provided by the employer) as continuation of item 11. If there is no documentary certificate to be added to the list of annexures, please do not add an entry to the employment history. 6. In the items 13 & 14 provide descriptive and precise statements which are reflective in nature. These items should demonstrate the capability of the candidate to organise thoughts as well as ability to articulate materials about oneself in modest, realistic but in persuasive manner. 7. After 25 th April, 2019, you will be able to download the admit cards from the website. If you find any difficulties contact us on admission4publicpolicy@nls.ac.in. 8. In addition to the application form, we encourage you to submit a two page Curriculum Vitae (CV) in any of the desired formats. However, do not repeat the information provided in the application, such as educational qualifications and employment history. CV should be used as an opportunity to spell out some achievements that may not be captured in the application format. 9. Send the Demand Draft of Rs.1000 (in favour of Registrar, National Law School of India University payable at Bangalore) along with the application form. Enter the details of Demand Draft in item no. 15 Send the duly filled application form and list of annexures as listed above to: Admission Coordinator, Integrated Ph.D. in Public Policy, National Law School of India University, Nagarbhavi Bangalore 560 072. Tel. +91 80 23160531; Mob. +91 9986098655 Note to mark the packet containing the application with Integrated Ph.D. in Public Policy Last Date to receive application form: 15 April 2019 8