CENTRAL UNIVERSITY OF KARNATAKA
Application Form for Admission to M.A. (Kannada / English), M.Com. / MBA
& M.Phil. and Ph.D. courses
USE SEPARATE FORM FOR EACH COURSE
(Please read instructions in Prospectus carefully before filling. Candidate will be held responsible for all errors / omissions.)
FILL IN BOTH APPLICATION AND HALL TICKET FORMS AND RETURN. DO NOT DETACH HALL TICKET FORM
1. NAME …………………………………………….………….. (as recorded in matriculation certificate)
2. FATHERS NAME ………………………………………..
3. DATE OF BIRTH………………
4. ADDRESS ……………………………………………………………………………….....................
………………………………………………………………………..PIN ……………………………
5. CONTACT INFORMATION Phone (STD code)………. (No)………….. CELL…………………..
Email ……………………………………
6. EDUCATIONAL QUALIFICATIONS (attach self-attested photocopies of relevant certificates)
Qualification
Board / University
Subjects studied
Year of Passing
Aggregate (in %)
X class
XII class
Undergraduate
Postgraduate
M.Phil.
Post – doc
Any other (Specify)
7. CATEGORY (tick one) SC / ST / OBC / PH / OTHERS (Please specify) ………………… (attach self-attested photocopy)
8. COURSE APPLIED FOR (please tick the course clearly and legibly. Use separate form and deposit fee separately for each additional course).
M.A.
M.Com.
MBA
M.Phil.
Ph.D.
English
English
English
Kannada
History
History
Geography
Geography
Psychology
Economics
Kannada
Psychology
Kannada
9. Preferred Centre for entrance exam ………………………. 10. Centre Code …………………
11. DETAILS OF FEE PAID: DD No…………, date…….., Amount………………, Bank
SIGNATURE OF CANDIDATE
CENTRAL UNIVERSITY OF KARNATAKA
HALL TICKET FOR ENTRANCE EXAM (2011)
NAME ………………………………………………. ………….. (as recorded in matriculation certificate)
FATHERS NAME ……………………………………….. ADDRESS………………………
…………….…………………………………………………….PIN ……………………………
COURSE / SUBJECTS ………………………………………..……………………………………..
CENTRE……………………………………..
SIGNATURE OF CANDIDATE
Affix self attested colour photo here and sign with black ink in box below.
Affix self attested colour photo here and sign with black ink in box below.
Sl.No……………..
H.T.No…………………
(To be filled by office)