Documente Academic
Documente Profesional
Documente Cultură
UG PG UG PG PG UG PG PG
4. Sex M F 5. Date of Birth Date Month Year Age as on Ist July 2009
11. Nationality
12. Name of Father 13. Name of Mother
14. Name of Guardian 15. Relationship
16. Religion 17. Caste
18. Seat Category General NRI
19. Category Reservation E/T SC ST Muslim OBH OBX LC Anglo Indian
District District
Pincode Pincode
Tel. No. Tel. No.
with code with code
*Candidates are requested to go through the brochure before filling the application form
23. Details of the Qualifying Examinations (to be supported by copies of mark lists and certificates)
Exam University/ Reg. No Year/ Subject Max Marks % Class No.of
Board Month Marks Secured Chance
Plus Two/ English
Pre-Degree 2nd Language
Optional Subjects
1
2
3
4
Grand Total
Graduation English
2nd Language
Main Subject/Optionals
Subsidiaries
1
2
Total for Main & Subsidiaries
Grand Total
Post
Graduation
Others
24. Experience
Designation Institution From-To Total Years Registration No.
Demand Draft No. *Amount in Rs. Date of Issue Issuing Bank Name of Branch
30. Declaration: I do hereby declare that the statement given in the application are true to the best of my knowledge and belief.
The original certificate shall be produced during the time of interview or admission, I know that if the information given is found
to be fradulent, I shall be liable for criminal prosecution. I have gone through the instructions in the admission brochure and I
agree to abide by the rules and regulations and conditions prescribed by the University for admission to the course. I agree to pay
the prescribed fees stipulated by the University. I also agree to be transferred to a different centre of study if the University
decides to do so.
In response to your application for admission to the above mentioned course, you are requested to appear for an entrance test
8. Venue of Test
9. Name and address of the candidate 10. **Name and designation of the Gazetted Officer with seal
13. Date
Check List
9. Please check whether your application form contains the following:
i) Self attested copies of the mark lists of the qualifying and other examinations.
ii) Self attested copies of the pass certificate / certificates/ provisional certificate of the qualifying
examination.
iii) Self attested copy of the transfer certificate.
iv) Self attested copy of the income certificate, (If needed)
v) Self attested copies of the relevant S.S.L.C. page to prove age.
vi) Self attested copies of the certificate to prove claims based on reservation (caste), children of ex-service
personnel, employees of the University etc.
vii) Filled in admission card. (only if the course has an entrance test, by the University).
viii)Two self addressed and stamped envelopes (Rs. 5/-) (size 24 cm x 12 cm). Only one is needed if the course
does not have entrance test, by the University).
ix) Those who apply in the downloaded form has to remit Rs.500/- as fee (for SC/ST candidates Rs. 200/- +
Rs.150/- = Rs.350/-)
x) Those who apply in the printed format available in the regional centres has to remit Rs. 300/- as registration
fee (for SC/ST candidates Rs.150/-)
10. Use pen having either pure black or pure blue ink only to fill in the application form.