Cash Coupon No ...................... dated ........................ Rs .......... ..
Bank Draft No ........................... dated ......................... Rs .......... ..
Signature of the official
(Office Sea])
For SC/ST Candidates
Passport size
photograph is
to be attached
Application Form for VBRET (Visva-Bharati Research Eligibility Test)
VISVA-BHARATI
SANTINIKETAN

(Applied against Advertisement No ...................................................... Dt. ............... , .............. )
Admission sought to .................................................... Bhavana/Vibhaga
.. .. ....................................................................... Departrnent
[While filling up the form please put tick mark in the appropriate boxes as the case may be]
Category of studentship: Resident D Day scholar D
Partially resident teacher candidate Others (Please specify)
Qualified : RET D NETD SET D
(Attach supporting document(s)
1. Name in Full (in capital letters) : .................................................................................................... .
2. Sex : Male D Female D
3. Date of Birth: Date .................................. Month .................................... Year ............................ .
4. Marital Status: Married D SingleD
5. Nationality: ........................................ .
6. Whether belong to:
(Attach supporting certificate duly attested)
7. Address of the applicant :
(a) Present :
(b) Permanent :
General Caste :
Other Backward Class:
Scheduled Caste :
Scheduled Tribe :
Physically Handicapped:
Minority:
Others:
D
D
D
D
D
D
D
Contd ....
8. Father's/Husband's name (in full):
Address:
Occupation :
9. Guardian's name (in full), if father, husband is not the guardian:
(a) ·····················································································, ... , .... , .. ........ , ...... , .... ···,····,···············,·····
(b) Guardian's relationship with the candidate:., ................ , ................... , .............................. , ........... .
(c) Address : .................................................. , ....................................... , ............................................ ..

10. Particulars of the candidate's previous education :
--------
Level Name of the Name Name of the Duration Year of
(with Examination ofthe Board/Council/ of the passing
duration appeared/ School/ University course
of the passed College
course) ·-·
11. (a) Research experience, if any, give details.
(b) field of experience, if any, including nature and period
(c) List of publications, if any, Give details in a separate sheet.
12. Broad field of the proposed research work- (A synopsis of the proposed wok is to be given in a separate sheet.)
N.H.: The form is to be accompanied by:
Subjects Division
studied/ Class
offered obtained
(i) Attested copies of mark sheets of all examinations passed as stated in Sl. No.IO:
(ii) Attested copies of all Certificates/Diplomas as sated in Sl. No.lO:
Date: ................................................. ..
Percentage
of marks
obtained
Signature of the Applicant
Price: U.s.l40/- for SC/ST