application form 2010-2011

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  • 8/9/2019 Application Form 2010-2011

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    MAHATMA GANDHI UNIVERSITY

    Application Form for Admission to UG and

    PG Programmes of Self Financing Schools, 2010-11

    Note: Make Entries in Capital Letters only and Tick ( ) in the boxes of Relevant Entries.

    Appl: No.

    1. Course /Courses opted for

    Photograph (bust)

    (to be attested by a

    gazetted officer by

    signing over the

    photograph with

    date)

    2. Name of School Name of Course (for PG only) 1

    2

    3. Name of the applicant 3

    4

    4. Sex M F 5. Date of Birth Date Month Year Age as on Ist July 2009

    6. Place of Residence 7. Panchayat / Municipality

    8. Taluk 9. District 10. State

    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

    Ward of M.G.U. Employee Diploma Holder Ward of Ex- Service Men

    20. Mobile No.

    21. Permanent Address 22. Address for Communication

    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

    OBH OBX LC Anglo Indian

    UG

    STAS SCIS DLIS SALSSME

    PG UG PG UG PGPG PG

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    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.

    25. Achievements in sports and Games

    Item Position Level-University / State/National Year Organised By

    26. Participation in NSS/NCC

    Certificate No. Name of Course & Year Reg. No. & Year of Other Information

    College Exam Examination

    27. Whether Orthopaedically handicapped

    Yes No If Yes, give details

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    28. Annual family income Rs. Rupees in words

    29. Particulars of the Fee

    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.

    Name & Signature of Applicant...................................................................................................................................................

    Name & signature of Parent / Guardian......................................................................................................................................

    Place.......................................... Date............................................

    31. ** Name and Designation of the attesting Officer with seal.

    To be filled in by candidates applying for course having entrance test by MG University

    Mahatma Gandhi University

    Entrance Test 2010

    Admission Card

    Note: Make Entries in Capital Letters only and Tick () in the boxes of Relevant Entries

    1. Name of the School & Centre

    2. Name of the course

    3. Name of the student

    In response to your application for admission to the above mentioned course, you are requested to appear for an entrance test

    4. Serial Number 5. Register Number

    6. Date 7. Time From To

    8. Venue of Test

    9. Name and address of the candidate 10. **Name and designation of the Gazetted Officer with seal

    11. Sex Male Female

    12. Signature of the candidate

    13. Date

    N.B: Candidate may fill in the items 1,2,3,9,11,12, and 13;

    **Gazetted Officer should sign on the photograph and affix the seal.

    Photograph (bust)

    (to be attested by a

    gazetted officer by

    signing over the

    photograph with

    date)

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    How to fill the Application Form1. Item (1) Please put a tick in the relevant box.

    2. Item (2) Write the name of the school as seen in the brochure. Those who apply for PG course;

    specify the name of the course.

    3. Items (3,4,5,11,12,13,16,17) Make entries as shown in the S.S.L.C. Book. For details refer general

    instruction.

    4. Item (5) The following pattern may be followed. E.g. if the date is 7th June 1986 write 07 06 - 1986

    5. Item (23) All the entries of the relevant columns should be made.

    6. Filled in admission card should also be sent along with the application. (Admission card is needed only if

    the course selected has an entrance test, by the University).

    7. On the top of the envelope write the following (as the case may be):- Name of the courses and subjects,

    whether post basic, NRI, entrance test, course opted for, reservation status etc.

    8. Two recent photographs (bust) attested by Gazetted Officer should be pasted. One on the application form

    and the other on the admission card.

    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.