Dr. Babasaheb Ambedkar International Convention Centre, Nagpur Registration Form

Dr. Babasaheb Ambedkar International Convention Centre,
Nagpur

Research Centre Membership Form

APPLICATION FORM RESEARCH CENTER MEMBERSHIP

Registration Form

Applied For	Research Center Membership-2026

Personal Details

Applicant's Full Name*

Gender*
Male Female

Date of Birth*

Aadhar No.*

Permenant Address*

Correspondence Address* Same as present address

Mobile No.*

Email ID*

Qulification Details

Graduation*

Graduation Subject*

Name of Graduation University*

Post-Graduation*

Post-Graduation Subject*

Name of Post-Graduation University*

Research Details

(Only the topic related to Dr. Babasaheb Ambedkar and the movement of emancipation and social change will be permitted for admission to the Research Centre)

Date of Qualifying PET Exam*

Ph.D. Registration/Enrollment No.*

Title of Thesis*

Subject of Thesis*

Date of Acceptance of Synopsis*

Name of University*

Name of Research Center*

Name of Guide*

Research Centre Allotted by the University Concerned ?*

Progress and Status of the Research Work on the Date of this Application*

Period for which Admission Saught*

Is the Ongoing Research Work is Full Time ?*

Details If Engaged in Other Task than Regular Research Work?*

Declaration:

I hereby declare that the information given above is true to the best of my knowledge. I shall abide by the rules of conduct and regulations of the Research Centre framed by the authorities of Dr. Babasaheb Ambedkar International Convention Centre.