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Mother Teresa Women’s University

KODAIKANAL – 624 102.

App. No.

Application for M. Phil(Full Time & Part Time)

ONLY FOR WOMEN

Affix recently taken passport size photograph in the space provided below and get it attested by Grade A/B Officer of the Central / State Govt. or Head Institution last attended.

Last date for receipt of application is ……………… with the registration fee of Rs…250/-……… (in the form of SBI Demand Draft drawn in favour of The Registrar, Mother Teresa Women’s University, Kodaikanal – 2.)

(For office use)

Passport size Photo


Date of Admission :

Fee Particulars :

Amount :

Date of Payment :

Indicate the Course

Indicate the centre
Kodaikanal Chennai
Madurai
1.Name of the Applicant as in SSLC certificate (IN BLOCK LETTERS)
2. Date of Birth
Date Month Year

Age


3. Religion & Nationality
4. Community :

(Tick appropriate Box)

Attested Xerox copy of the community certificate from

the Revenue authorities must be attached with the

application

O.C. B.C. M.B.C S.C. S.T.

D.N.C

5. Father’s / Guardian’s Name and



occupation (If employed : Indicate the organization)

6. Annual income of the Parent / Guardian


7. Mailing address with Pincode, to which communication is to be sent (in block letters).

PIN


TALUKDISTRICT
8. Name of the college in which previously studied and year of study.

From …………….To……………….


9. Academic Record


Name of the Examination

Subject

College / Institution / University

Year of Passing

Percentage of Marks

Grade /

Class

















10. Department of Mother Teresa Women’s

University in which the applicant proposes to

undergo the M. Phil. Degree course



(Please mark against the relevant Department )

15.Foods and Nutrition

16.Education

17. Food Service Management & Dietetics

18. Textiles and Clothing

19. Mathematics

20. Visual Communication

21. Psychology

22. Mass Communication

23. Music

24. Management Studies

25. Guidance & Counseling

Full Time, Part Time Evening)

26. Library Science
1. English

2. Computer Science

3. Tamil Studies

4. Historical Studies

5. Tourism Management

6. Library Science

7. Commerce

8. Women’s Studies

9. Sociology

10. Economics

11. Chemistry

12. Bio Technology





13. Botany

14. Physics

11. If the candidate is employed, whether she has

obtained necessary permission from the Head

of the Institution to undergo the Course.

(the letter granting permission to be attached)

Station

:

Date : Signature of the Applicant



Signature of the Head of the Institution

(Where the candidate is working as a teacher)

Enclosures required Attested Xerox copies of


  1. Evidence for Date of Birth

  2. Transfer Certificate

  3. Community Certificate

  4. P.G. Mark Sheet

  5. Attested Copy of Degree or Provisional Certificate

  6. Letter from the Head of the Institution granting permission

Candidates should have taken the Degree at a Convocation before supplicating for the M.Phil. Degree.
Note: If the application is downloaded, the application cost of Rs. 150/- should be added and also the Registration fee of Rs. 250/- may be paid in the form of Demand Draft drawn in favour of “The Registrar, Mother Teresa Women’s University”, Kodaikanal – 624 102.


  1. DECLARATION OF THE PARENT / GUARDIAN

The information furnished above is true and correct to the best of our knowledge. The original certificate will be produced at the time of admission or on demand. In case any information furnished above is found incorrect, we agree to forego any claim for admission.

Station : Signature Parent / Guardian

Date :
EXCLOSURE: (Xeroxed)



  1. Evidence for Date of Birth 6. Income Certificate

  2. Community Certificate 7. Registration fee Rs.

  3. Transfer Certificate SBI D.D. drawn in favour of

  4. Conduct Certificate The Registrar, Mother Teresa Women’s University, Kodaikanal.

  5. Mark Sheet

CODING SHEET (U.G.)

(To be filled in by the Candidate)
1. Course Applied :

2. Application No. :

3. Name :

4. Sex :

5. Date of Birth & Age :

6. Father’s Name :

7. Mother’s Name :

8. Address for Communication :

PIN :

TALUK :


DISTRICT :

PHONE NO. : STD Code No. Ph. No.

9. Community :

10. Subject studied with marks :


11. Percentage of Marks :



12. Physically Handicapped / Sports :


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