KARNATAKA STATE OPEN UNIVERSITY
Manasagangotri, Mysore – 570 006, Karnataka, India
&
SCOPE, Bangalore - 24
RE-SITTING FORM FOR DECEMBER/JUNE_________________ EXAMINATION

1. Enrollment No. / Roll No. of the Student 2. Study Centre Code
3. Full Name of the Student (As registered with the University)
4. Father’s Name (As registered with the University)
5. Complete address for Correspondence (Do not repeat name)
Telephone No. with STD Code Pincode
6. Name and code number of subject in which candidate is re-sitting:
Number of theory subjects Number of practical subjects
7. Bank draft number with details
Bank Name Amount in Rs. DD Number DD Date
a. I Certify that I have read and understood all the provisions indicated in the prospectus and the Circulars published in the website www.ksoukarnataka.com from the
time to time.
b. I Certify that after being fully satisfied with this course I have decided to get enroled out of my own free will and desire.
c. I further certify that same is done without any inducement and misrepresentations either from the said University or other person concerned.
d. I shall abide by this undertaking and shall not hold anybody responsible for the same in any manner either during running of course or on its Completion.
e. I hereby certify that all the particulars stated in this application are true to the best of my knowledge & belief. In the event of suppression or distortion of any fact made in
my application form, I understand that my admission is liable to be cancelled. I understand that university has the right to add/delete/change the syllabi.
course structure, rules & regulations as and when required, as per change in environment.
Declaration By the Applicant
COURSE STREAM SEMESTER PAPER CODE NAME OF THE SUBJECT
8. Certificate by Center Co-ordinator: Study Center Code
Certified that the Enrollment Number, Name, Examination Particulars have been verified
and found correct as per the word.
Signature & Seal of the Center Head of the Study center Date :___________________
Specimen Signature of the Candidate
Note :- Last Date for submitting re-sitting applications. (Calendar of Events already given on Universities website.)