KARNATAKA STATE OPEN UNIVERSITY
MUKTHAGANGOTRI, MYSORE - 570 006
2013-14
APPLICATION FOR ADMISSION TO IIIRD YEAR B.A / B.Com DEGREE PROGRAMME 2013-14
Note: (1) Please follow the Instructions given in the Circular. (2) Students are advised to Put a ()mark against the column No. 1, 2, 3, 6 & 7
1. Regulation Applied for
2.Medium / 3. Admission
Sought
III B.A III B.Com
5. Name of the Applicant
(in Block Letters)

8. Address for
Correspondence
11. Details of Fee Paid
12. Centre opted earlier
4. Roll No/ ID No.

SIM
RI RII
English Kannada
7. Caste/
Category
(Indicate)
SC ST I IIA IIB IIIA IIIB GM
1.
2.
3.
9. Optional Amount Challan No. Name of Bank
Signature of the Candidate
6. Sex
Male Female
Case Worker Supt Asst. Registrar Dy. Registrar(Admission)
10.Contact Numbers Mobile No:
Pin Code
Signature of the
Receiving Officer
To be sent to the SBM Code No. 4166, Manasagangotri Branch,
Mysore-6 / SBI New Sayajirao Road, Mysore-1 (Code : 3130) Student Copy - (no separate receipt will be issued)
Signature of the
Receiving Officer
Signature of the
Receiving Officer
Signature of the
Receiving Officer
Off/Res :
Roll No. ..................................................................
Subjects : Opt 1...........................Opt 2............................Opt 3 ........................
Sri / Smt.....................................................................................................................................................................
........................................................................................................................................................................................
............................................................................................................................................................................................
III rd Year B.A / B.Com Medium Kannada English
Phone No. - - - - - - - - - - - - - - - - - - - - - - - - - -
PIN
(Please write your address in Block Letters)
Roll No. .................................................................
Subjects : Opt 1...........................Opt 2............................Opt 3 ........................
Sri / Smt..........................................................................................................................................................................
........................................................................................................................................................................................
............................................................................................................................................................................................
III rd Year B.A / B.Com
Phone No. - - - - - - - - - - - - - - - - - - - - - - - - - -
PIN
(Please write your address in Block Letters)
Date: Signature of the Remitter KSOU COPY
STUDENT COPY
SBM/SBI MYSORE COPY
BANK COPY
"GENERAL FUND ACCOUNT" SBM 54035420117
SBI 31051187090 Programme / Subject: ---------------------
Place of Remittance ---------------------------------------------
S.B.M. Manasagangotri , Mysore-6 (Code : 40166)
S.B.I. New Sayyajirao Road, Mysore-01 (Code : 3130)
Roll No. ID No.
Name & Address of the Student
Programme/ Tuition Fee Rs. ..............................
Penal Fee Rs. ..............................
Re-enrolment fee Rs. ..............................
Total Rs. ..............................
Amount in words : Rupees ..................................................
..............................................................................................
FOR THE USE OF THE BANK
The amount of Rs. ............................................ (in words)
Rupees..................................................................................
Date & Bank Seal
Karnataka State Open University, Mysore
CHALLAN FOR RENEWALS : IIIrd year B.A/B.Com 2013-14
"GENERAL FUND ACCOUNT" SBM 54035420117
SBI 31051187090 Programme / Subject: --------------------
Place of Remittance --------------------------------------------
S.B.M. Manasagangotri , Mysore-6 (Code : 40166)
S.B.I. New Sayyajirao Road, Mysore-01 (Code : 3130)
Roll No. / ID No.
Name & Address of the Student
Programme/ Tuition Fee Rs. ...............................
Penal Fee Rs. ...............................
Re-enrolment fee Rs. ...............................
Total Rs. ...............................
Amount in words : Rupees ...................................................
...............................................................................................
FOR THE USE OF THE BANK
The amount of Rs. ............................................ (in words)
Rupees...................................................................................
Date & Bank Seal
Karnataka State Open University, Mysore
CHALLAN FOR RENEWALS : IIIrd year B.A/B.Com 2013-14
"GENERAL FUND ACCOUNT" SBM 54035420117
SBI 31051187090 Programme / Subject: --------------------
Place of Remittance --------------------------------------------
S.B.M. Manasagangotri , Mysore-6 (Code : 40166)
S.B.I. New Sayyajirao Road, Mysore-01 (Code : 3130)
Roll No. / ID No.
Name & Address of the Student
Programme/ Tuition Fee Rs. ...............................
Penal Fee Rs. ...............................
Re-enrolment fee Rs. ...............................
Total Rs. ...............................
Amount in words : Rupees ...................................................
...............................................................................................
FOR THE USE OF THE BANK
The amount of Rs. ............................................ (in words)
Rupees...................................................................................
Date & Bank Seal
Karnataka State Open University, Mysore
CHALLAN FOR RENEWALS : IIIrd year B.A/B.Com 2013-14
"GENERAL FUND ACCOUNT" SBM 54035420117
SBI 31051187090 Programme / Subject: --------------------
Place of Remittance --------------------------------------------
S.B.M. Manasagangotri , Mysore-6 (Code : 40166)
S.B.I. New Sayyajirao Road, Mysore-01 (Code : 3130)
Roll No. / ID No.
Name & Address of the Student
Programme/ Tuition Fee Rs. ...............................
Penal Fee Rs. ...............................
Re-enrolment fee Rs. ...............................
Total Rs. ...............................
Amount in words : Rupees ...................................................
...............................................................................................
FOR THE USE OF THE BANK
The amount of Rs. ............................................ (in words)
Rupees...................................................................................
Date & Bank Seal
Date: Signature of the Remitter Date: Signature of the Remitter Date: Signature of the Remitter
Medium Kannada English
(To be retained with the receiving Bank)
Students can continue their studies in the Final year irrespective of their result of the I & II year B.A/B.com Examination or even if they have do not appeared for the Examinations, shall also Remit final year Tuition Fee.
Instructions to students who would desire to obtain Study Materials in - person
1. Students who would like to obtain Study Materials in-person after remitting the admission fee, have to submit compulsorily their
Identity card and photo copy of fee paid Challan in the Renewal Form.
2. It is better, if students collected their Study Materials in-person, (Study Materials will not be issued to the parents or any other person who comes on behalf of the students) after checking the particular of Study Materials of their programme. In case it is not possible for any student to come in person, Study Materials will be despatched for such students only after verifying their admission.
3. Students seeking admission after a break of ONE year will have to pay a Re-Enrolment fee of Rs.1000/- for TWO Years break will have to pay of Rs. 2,000/- along with regular tuition fee. Those students who have discontinued their studies for more than two years are not eligible for re-enrolment.

Notice : 1) Students admitted for IInd Year B.A./B.Com at the Regional Centres in the Academic Year 2012-13 can directly submit the IIIrd Year Renewal form at the respective Regional Centre to get admission.
or
2) Students wish to get admission through Post / Person can directly visit to Mysore head office to get the Study Material in person or they can send the Renewal Application by post to the above mentioned address to get the lessons through post.