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Study Centre Code:: Downloaded Application For Admission

This document is an application form for admission to the School of Distance Education at Bharathiar University in Coimbatore, Tamil Nadu, India. The form collects information such as the applicant's name, date of birth, gender, address, contact details, nationality, religion, community, course details, and educational qualifications. The applicant must declare that the information provided is correct and agree to abide by the university's rules and regulations. The form also collects payment details and has sections for office use to note if the applicant is educationally qualified, any fee concessions, and the admission decision.

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Seyed Ibrahim
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65 views2 pages

Study Centre Code:: Downloaded Application For Admission

This document is an application form for admission to the School of Distance Education at Bharathiar University in Coimbatore, Tamil Nadu, India. The form collects information such as the applicant's name, date of birth, gender, address, contact details, nationality, religion, community, course details, and educational qualifications. The applicant must declare that the information provided is correct and agree to abide by the university's rules and regulations. The form also collects payment details and has sections for office use to note if the applicant is educationally qualified, any fee concessions, and the admission decision.

Uploaded by

Seyed Ibrahim
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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SCHOOL OF DISTANCE EDUCATION

BHARATHIAR UNIVERSITY : COIMBATORE - 46. TAMIL NADU, INDIA.






[Application should be clearly filled-in with CAPITAL LETTERS by the candidates own handwriting in English. Please tick ( ) where ever necessary]


[Not Applicable for First Year]

Name of the Candidate
As per the SSLC / HSC Record
_______________________________________________________________

Date of Birth d d

m m y y y y

Sex: M F T
Affix a Recent
Passport Size Photo
Here


NO ATTESTATION

DONT STABLE
Name of the Father /
Mother / Guardian / Husband
__________________________________
Address ______________________________________________________
______________________________________________________________
___________________________________Pin: _____________
Applicants Specimen Signature
[inside BOX]
1
2

District: __________________ State:_________________
Mobile:____________________ Phone:________________
Email ID: _________________________________________
Part-I Language
(For UG only)

Tamil Telugu Kannada Malayalam Hindi Urdu Arabic French

Concession claimed in
Tuition Fee:
if applicable
please tick ( )
Graduates of Bharathiar University
Teacher Police-Defense
Media-Press Ex-service men

[25%]





Physically
Challenged

[100%]
Women

[10%]

Fee Payment Particulars
Mode Number Date Amount Bank & Branch For office use only
DD
dd/mm/yyyy

Challan
DD
dd/mm/yyyy

Challan
Batch: ___________ Academic / Calendar Study Centre Code:

Name of the Study Centre:


Course Name Major / Branch
First Year

Direct

Second Year Lateral Entry
Third Year Re-admission
Enrol. No.
(For office use only)
Application No.:
DOWNLOADED APPLICATION FOR ADMISSION
Nationality: __________________ Religion: ___________________________

Community: SC SC(A) ST MBC DNC BC BC(M) OBC General

Are you already registered with (Regular/SDE) Bharathiar University? Yes No
If yes, Name of the course ______________________ Register No.:_________________

Elective /optional papers opted (Refer the course contents in the prospectus for elective / optional papers)
1. __________________________________ 2. _______________________________________

Qualifying examination passed (10+2+3/11+1+3/10+3+2/ others specify _________________)
Sl.
No.
Examination
Passed
Course
Name
Subject /
Major
Board / University Register No.
Year of
passing
% of
Marks
1. SSLC ***** *****
2.
H.Sc./ PUC / Pre-
Degree
*****
3. Diploma
4. UG
5. PG / PG Diploma

I, ___________________________________________________________________ hereby
declare that the particulars given above are correct. I abide by the rules and regulations of the Bharathiar
University. If any particulars given are found to be incorrect at any point of time, I will abide by the
decisions of the University.

Note: Admission to the course is purely provisional and the University reserves the right to withdraw the course at
any time due to administrative reasons.

Place:________________

Date:_________________

Signature of the Applicant




For Office use only
Educationally qualified Yes No
Concession Applicable Yes / No
Required certificates attached Yes No
Total Amount Paid Rs. ____________
Original certificates verified Yes No
Balance Amount Paid Rs. ____________

Admitted: Yes on ____________ No Reason_____________________________




ASO SO AR DR DIRECTOR

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