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    Application-form-PGDPHJ 2023 - 2024.

    Uploaded by

    71 Prince prabhakaran S
    The document is an application form for the Post Graduate Diploma in Public Health Journalism program at the Tamil Nadu Dr. M.G.R. Medical University for the 2023-24 academic year. It requests information such as the applicant's personal details, academic qualifications, payment details, and a declaration agreeing to abide by university regulations. Instructions are provided for correctly filling out and submitting the application along with the non-refundable processing fee. The form also contains a section for the applicant's identification card to be used at the entrance examination.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Application-form-PGDPHJ 2023 - 2024.

    Uploaded by

    71 Prince prabhakaran S
    29 views5 pages
    The document is an application form for the Post Graduate Diploma in Public Health Journalism program at the Tamil Nadu Dr. M.G.R. Medical University for the 2023-24 academic year. It requests information such as the applicant's personal details, academic qualifications, payment details, and a declaration agreeing to abide by university regulations. Instructions are provided for correctly filling out and submitting the application along with the non-refundable processing fee. The form also contains a section for the applicant's identification card to be used at the entrance examination.

    Original Description:

    Application for pg diploma mgr univ

    Original Title

    Application-form-PGDPHJ 2023 -2024.

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    The document is an application form for the Post Graduate Diploma in Public Health Journalism program at the Tamil Nadu Dr. M.G.R. Medical University for the 2023-24 academic year. It requests information such as the applicant's personal details, academic qualifications, payment details, and a declaration agreeing to abide by university regulations. Instructions are provided for correctly filling out and submitting the application along with the non-refundable processing fee. The form also contains a section for the applicant's identification card to be used at the entrance examination.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    29 views5 pages

    Application-form-PGDPHJ 2023 - 2024.

    Uploaded by

    71 Prince prabhakaran S
    The document is an application form for the Post Graduate Diploma in Public Health Journalism program at the Tamil Nadu Dr. M.G.R. Medical University for the 2023-24 academic year. It requests information such as the applicant's personal details, academic qualifications, payment details, and a declaration agreeing to abide by university regulations. Instructions are provided for correctly filling out and submitting the application along with the non-refundable processing fee. The form also contains a section for the applicant's identification card to be used at the entrance examination.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 5

    THE TAMIL NADU Dr. M.G.R.

    MEDICAL UNIVERSITY
    No.69, ANNA SALAI, GUINDY, CHENNAI –600 032.

    POST GRADUATE DIPLOMA IN PUBLIC HEALTH JOURNALISM


    (PGDPHJ) - 2023-24

    APPLICATION FORM

    Details of payment of fee For office use only


    (To be filled in by the Candidate)
    Name / Place of the Bank: Form No.

    Demand Draft /Challan No.: Eligible / Not Eligible:


    (D.D. / Challan should be enclosed)
    Date of Payment: Verified by:
    Amount Rs.:

    Paste a
    1. Name of the candidate (in Block Letters & Initials at the end): self-attested recent
    Passport size
    Photograph.

    2. Date of Birth and Age : Do not Staple


    (Proof to be enclosed)

    3. Address for Communication (with phone/mobile No./Email ID)

    4. Permanent Address :

    5. State of Domicile :

    6. Sex :

    7. Nationality and Religion :


    8. Community :

    (Proof to be enclosed)

    9. Name of Parent / Guardian / Husband :


    10. Academic Qualifications:

    S. No Examination passed Institution University/year of % of Mark


    passing Obtained

    1 Matriculation

    2 Higher Secondary

    3 U.G. Degree

    4 P.G. Diploma (If


    any)
    5 P.G. Degree

    11. Name of the Central Council :


    in which registered (if applicable)

    Registration No. and Date :

    12. Whether Eligibility Certificate obtained:


    (enclose photocopy)

    13. Whether Migration Certificate obtained :


    (enclose photocopy)
    DECLARATION BY THE APPLICANT

    I (Name in full and in Block letters)

    son/Daughter/Ward/Wife of hereby solemnly declare that all the information furnished

    and the statements given in the above application and the enclosures are true, correct

    and complete to the best of my knowledge and belief.

    I further declare that if it is found otherwise, I am liable to forfeit the seat and/or

    be removed from the rolls of the institution at whatever stage of study I may be, besides

    making be liable for criminal prosecution.

    I also declare that I had read all the instruction in the


    application/prospectus carefully and I will abide by the regulations/instructions of the
    University.

    Place:

    Date: Signature of the Applicant


    INSTRUCTIONS

    1. The cost for Processing/Registration of application etc. is Rs.885/- which is non-


    refundable.

    2. All columns in the application must be filled up legibly and signed only by the
    candidate.

    3. The said fee should be paid in the form of an account payee Demand Draft
    drawn in favour of The Registrar, The Tamil Nadu Dr. M.G.R. Medical University
    payable at Chennai (or) through a challan of the Indian Overseas Bank Branch located
    in this University Premises.

    4. Fees once paid will not be refunded under any circumstances.

    5. University has right to revise the tuition fee/exam fee from time to time.

    6. Intimations/Communications to the candidates about the entrance


    examination, interview, sending of hall tickets etc will be made only through
    email. Hence the candidates are requested to check their email regularly. The
    university will not be responsible if the candidates failed to check emails and for
    other consequences thereof.

    *********
    THE TAMIL NADU Dr. M.G.R. MEDICAL UNIVERSITY
    ENTRANCE EXAMINATION FOR
    POST GRADUATE DIPLOMA IN PUBLIC HEALTH JOURNALISM
    (PGDPHJ) - 2023-24

    IDENTIFICATION CUM ADMIT CARD

    Name of Candidate ( in BLOCK Letters)

    Specialty ( in BLOCK Letters) Paste a self-attested


    recent Passport size
    Photograph
    Do Not Staple
    Signature of the candidate

    For Use at Examination Centre only


    Date and Signature of the Candidate Signature of Invigilator
    Time

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