Proforma for Application

To,
The Director
PGT SFC Cell
I.P.G.T. & R.A.
Gujarat Ayurved University,
Jamnagar - 361 008. (Gujarat), India.

Sub.: Application for admission in the Course ..............................................................................

1. Name of the Applicant :

(In capital letters)

2. Father's Name :

3. Permanent Home Address :

4. Address for Communicaiton :

Ph. No :

Fax :

E-mail :

5. Nationality :

6. Category :

7. Date of Birth :

8. Sex :

Male

Female

9. Educational Qualificaitons:

Name of Exam	University	Year of Passing	Subjects	Percentage	Div./Class

10. Other relevant information :

11. Details of Applicaiton Fee :

For Foreign students only (column 12-16)

12. Passport No. :

Issued from:

13. Type of Visa:

Valid up to :

14. Expected date of arrival in India :

15. Date of arrival and address in India :

(If you are in India)

16. Whether self supproting or scholarship holder :

(Please attach true copies testimonials/proof for 5,6,7,9,10 and 11)

I hereby declare that the information give aboe is true. In case I am selected for the course, I shall abide by the rules and regulations of the University applicable to the course trainees/students and also the laws in force in the country binding on foreign nationals.

Date :

Place :

Signature of Applicant