EXAMINATION APPLICATION FOR FIRST/SECOND/THIRD YEAR B.A PROGRAMME Month...............Year.........

Mukthagangotri, Mysore - 570 006 KARNATAKA STATE OPEN UNIVERSITY

6.*Category

7.*Sex :

5.*Address of the Student for Correspondence (Do not write name again)

Single Mark ( ) is for shading the appropriate circle completely. e.g -

Entries must be filled by the candidates in** Capital Letters..

Instructions :

1.**Register Number

3.*Name of the Examination Center

4.*Name of the Candidate (As per SSLC)

NOTE :- Subjects/Papers for which to appear - Please shade the appropriate circle in front of subject appearing for the Examination.

2.* Year of Admission

Regulation :

R1 R2

- - -

Residence

Mobile

9. **Telephone Numbers (with STD code)

+91

0

SC ST GM.CAT-I OBC P.H

I II III

Male

Female

8.*B.A :

I II III

LANGUAGE (SELECT ANY TWO)LANGUAGE (SELECT ANY TWO)If passed writeyear & month

If passed writeyear & month

If passed writeyear & month

1. Kannada 1. Kannada2. English 2. English3. Hindi 3. Hindi4. Urdu 4. Urdu

7. Tamil 7. Tamil5. Sanskrit 5. Sanskrit6. Telugu 6. Telugu

OPTIONAL SUBJECT (SELECT ANY THREE) OPTIONAL SUBJECT (SELECT ANY THREE)

1. Kannada 1. Kannada7. Education 7. Education

8. Psychology 8. Psychology

9. Hindi 9. Hindi

10. Urdu 10. Urdu

11. Anthropology 11. Anthropology

12.Geography 12.Geography

2. English 2. English

5. Economics 5. Economics

6. a. Pol-Science

6. a. Pol-Science

b. Pub-Adminisration b. Pub-Administration(Select Any One) (Select Any One)

BPP Applies For Regulation I (R1) students only

Compulsory Optional Subject : ICHR & ES Compulsory Optional Subject : ICHR & ES

3. History 3. History

4. Sociology 4. Sociology

OPTIONAL SUBJECT (SELECT ANY THREE)

First Year Examination Second Year Examination

Third Year Examination

KANNADA (III)

ENGLISH (III)

KANNADA (IV)

ENGLISH (IV)

KANNADA (V)

ENGLISH (V)

HISTORY (III)

HISTORY (IV)

HISTORY (V)

SOCIOLOGY (III)

SOCIOLOGY (IV)

SOCIOLOGY (V)

ECONOMICS (III)

ECONOMICS (IV)

ECONOMICS (V)

POL-SCIENCE (III)

POL-SCIENCE (IV)

POL-SCIENCE (V)

PUB-ADMN (III)

PUB-ADMN (IV)

PUB-ADMN (V)

EDUCATION (III)

EDUCATION (IV)

EDUCATION (V)

PSYCHOLOGY (III)

PSYCHOLOGY (IV)

PSYCHOLOGY (V)

ANTHROPOLOGY(III)

ANTHROPOLOGY(IV)

HINDI (III)

HINDI (IV)

HINDI (V)

URDU (III)

URDU (IV)

URDU (V)

ANTHROPOLOGY(V)

GEOGRAPHY (III)

GEOGRAPHY (IV)

GEOGRAPHY (V)

I declare that the above information furnished by me is correct to the best of my knowledge.

Date ...........................

.............................................

Place............ .............. Signature of the Candidate

FOR OFFICE USE ONLYAccepted / Rejected

Scrutinized by Checked by

............................ ............................

IMPORTANT INSTRUCTIONS TO BE FOLLOWED BY THE CANDIDATE

1. Please read carefully the instructions given in the application, as well as in the prospectus and fee circular before filling the application.

2. IT IS COMPULSORY FOR THE CANDIDATE TO ENCLOSE ATTESTED PHOTO COPIES OF THE PREVIOUS YEAR MARKS CARDS WITHOUT FAIL.

3. The application along with the Examination (original) and Admission (xerox copy) Fee paid challans should be submitted on or before the due date (with or without penal fee as prescribed in the fee circular). Otherwise, the application will be rejected.

4. Freshers, who have enrolled for I, II or III year B.A. course in the current academic year should compulsorily pay the examination fee in full and must appear for all the subjects/papers in their respective class.

5. Incomplete applications are liable to be rejected.

6. The prescribed examination fee should be remitted in the bank through the challan printed in the examination form.

7. Examination Fees once paid will not be re-adjusted / refunded under any circumstances.

8. Regarding the rates of Examination Fees, separate Circular is enclosed.

9. For all instructions pertaining to the examination Dates, Centres, Assignments, Time Table, Announcement of Result, Convocation Dates etc., please see the KSOU Website:www.ksoumysore.edu.in.

10.The filled - in application should be submitted to the REGISTRAR (EVALUATION), Karnataka State Open University, Mukthagangotri, Mysore - 570 006.

11. MOBILE PHONES ARE STRICTLY PROHIBITED IN THE EXAMINATION HALL.

KSOU

COPY

KSOU-500-EXAMINATION FUND

Name of the Bank &

Place of Remittance..............................................Name of the Course B.A : I / II / III

SBM : 54035420128 SBI : 31106997538

Karnataka State Open University, Mysore

Roll No :

ORIGINAL

SBM, Mukthagangotri, Mysore - 06 Code -40166SBI, New Sayyaji Rao Road, Mysore - 01 - Code-3130

Amount Rs.

501 : Examination Fee : Penal Fee : Change of Centre Fee :

Amount ( in words) Rupees ......................................

...................................................................................Note : Fees once paid will not be Refunded.

Date : Signature of Remitter____________________________________________

For the use of the Bank

The Amount of Rupees ( In words).............................

.....................................................................................has been received / Challan No.Date & Bank Seal Signature of the Officer receiving the money UNIVERSITY COPY Not to be separated from the Form

Name and Address of the Student

10. Sex: Male / Female

12. Year in which Candidate completed the Programme

13. Details of the fee paid :

Year Amount Paid

BPP Exam Appeared / Not I Year II Year III Year

Name of the Bank Challan No. Date

I Year

II Year

III Year

11. Medium : Kannada / English

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