KRISHNA KANTA HANDIQUI STATE OPEN UNIVERSITY
Bachelor Preparatory Programme EXAMINATION, (................... Session) 20......
Form No./Ex-1
NAME OF THE STUDY CENTRE :
1. Enrolment Number : (as in enrolment certificate)
2. Name of the Candidate : (in BLOCK letters only)
First Name Middle Name Last Name
3. Father’s Name : (in BLOCK letters only)
4. Mother’s Name : (in BLOCK letters only)
5. Complete Address :
________________________________________________________________________________
________________________________________________________________________________
_____________________________________________________ Pin : ______________________
6. Caste (): General ; SC ; ST ; ST (Hills) ; ST (Plain) ; OBC ; MOBC
7. Sex : Male ; Female ; 8. Religion
9. Subject taken () : English Basic Mathematics MIL
Political Science Economics History
Book keeping Business Studies Commercial Arithmetic
Basic Electronics Adv Maths Fundamentals of Computer Sc.
10. Medium of Examination () : English Assamese Hindi Bengali Boro
11.Educational Background () : Up to HSLC ; HS appeared but not successful
HSLC passed ; HS Passed (Arts) ; HS Passed (Sc.) ; (Commerce)
Passport size
photograph
to be
pasted
Full signature of
the Candidate
To,
The Controller of Examinations
K.K. Handiqui State Open University
Housefed Complex, Dispur,
Guwahati-6
Sir,
I request permission to present myself as a candidate in the ensuing B.P.P. Examination, ( )20........... of Krishna Kanta Handiqui State Open University.
If any of the statements made and particulars furnished in the application is found to be not true or if it appears that in the opinion of the University, I have contravened any of the provisions of the rules and regulations of the University relating to the BPP examination, my admission to the Examination will be liable to be cancelled.
The fees shown hereunder are forwarded herewith --
i) Examination Fee (Rs. 75.00 per paper): Rs. 450.00
ii) Marksheet Fee : Rs. 50.00
iii) Centre Fee : Rs. 200.00
_________________________
Total Rs. 700.00
Yours obediently
Date : (Full signature of the candidate )

CO-ORDINATOR’S CERTIFICATE
I certify that the candidate named above is a duly enrolled student in _________________
Course of this Study Centre and that --
1. He/she has completed the requirements to appear in BPP Examination.
2. His/her conduct has been good.
3. He/she has filled in the particulars himself/herself and put his/her signature in the application in my presence and I believe the subjoined accounts are true.
4. I know nothing against his/her moral character.
5. He/she has not availed of more than 4 chances of appearing in Exam.
6. He/She got Back in Paper_______
(Photocopy of marksheet to be attached)
Date : Seal Signature
Name :
Co-ordinator
Accepted
OSD (Examination)