pg.

1


APPLICATION FORM
DEPARTMENT OF COMPUTER SCIENCE
UNIVERSITY OF LUCKNOW
LUCSAT-2014
M.C.A. Admissions 2014
For office use only

Form No. Roll. No.


(To be filled by the candidate in his own handwriting)

1. Name (Mr./Ms.)
2. Mothers Name & Occupation...
.
3. Fathers Name & Occupation ....
.
4. Annual Income (per Annum) .
5. Date of Birth....

6. Local Address..
......
.....
Pin Code .
Mobile No....
E-Mail..
7. Permanent Address
......
.....
Pin Code .
Mobile No....
E-Mail..
8. Educational Qualification

Examination Passed
University/
Board
Year % of Marks Subjects Offered
High School/Equivalent.
Intermediate/Equivalent
B.Sc.(CS/CA)/B.Sc.(IT)/BCA/
B.E/B.Tech

I
st

I
st

Sem



II
nd

Sem



II
nd

III
rd

Sem



IV
th

Sem




III
rd

V
th

Sem



VI
th

Sem




Professional (Specify)






Paste
Recent
Self-attested
Passport size
Photograph facing
the camera
(Self-Attested)

pg. 2
9. Category:

Vertical Reservation

General OBC SC/ST
Horizontal Reservation

UE CT PH

EA FF SPORT

Note : In case proper documentary evidence in support of claim under item 9 above is not enclosed,
the candidate shall be treated under General category.

10. Gender : Male Female

11. Extra Curricular Achievements:
S.No. Type of Activity



List of Enclosures: (Please tick)
1. Self attested photocopy of caste certificate if applicable

2. Attested Photo-Stat Copies of mark sheets, testimonials etc. should be enclosed with this
application form.

3. Bankdraft of Rs 800/- for General/OBC Candidate and Rs 400 for SC/ST
Candidate in favour of Finance Officer, University of Lucknow, Lucknow payable
at Lucknow.


Bank Draft details:
Name of issuing Bank Draft No. Date Amount


DECLARATION: I do hereby declare that the information furnished by me in respect of all
the above items is true to the best of my knowledge and belief. In case any of the above
information is found incorrect or false at any stage my admission shall automatically stand
cancelled.
Place:

Date: (Signature of the Applicant)
Note :
1. Incomplete forms will be subjected to rejection. The candidate
would have then no claim.

Please send the completed application form at the following address by Speed Post only on or before 12
th

August 2014.

Head,
Department of Computer Science,
University of Lucknow,
Lucknow 226007
India


pg. 3

DEPARTMENT OF COMPUTER SCIENCE
UNIVERSITY OF LUCKNOW
LUCSAT-2014
M.C.A. Admissions 2014
ADMIT CARD
For office use only

Form No. Roll. No.


1. Name (Mr./Ms.)

2. Fathers Name....

3. Date of Entrance Examination:

4. Examination Centre: ...




Head, Deptt. of Computer Science


**************************************************************************************

DEPARTMENT OF COMPUTER SCIENCE
UNIVERSITY OF LUCKNOW
LUCSAT-2014
M.C.A. Admissions 2014
VERIFICATION FORM

For office use only

Form No. Roll. No.


1. Name (Mr./Ms.)

2. Fathers Name....

3. Examination Centre:..

4. Applicant Signature.

5. (At the time of examination Only)

Date of examination Applicant signature Sign. Of Invigilator




Head, Deptt. of Computer Science





Paste
Recent
Self-attested
Passport size
Photograph facing
the camera
(Self-Attested)


Paste
Recent
Self-attested
Passport size
Photograph facing
the camera
(Self-Attested)

pg. 4



Rules for filling up the M.C.A. Application Form of LUCSAT-2014:

1. The Application form will be available only at the website
<www.lkouniv.ac.in> from which it can be downloaded
2. The Application form must be filled in Capital letters by the candidate in
his/her own handwriting.
3. Incomplete Application forms will be subjected to rejection. The candidate
would have then no claim.
4. The Xerox copy of the properly filled Application Form must be kept by the
candidate, which can be treated as the proof of filled form when produced
along with postal receipt.
5. The Candidates have to submit two set of Xerox copy of relevant
Certificates/Mark sheets along with originals.
6. For Duplicate Admit Cards, the candidate has to bring two attested
photographs and the Xerox copy of the application form.
7. The existing reservation rules of the University shall apply in admitting the
students to M.C.A. course.
8. All legal matters shall be subject to Lucknow Jurisdiction only.
9. The Semester fees must have to be submitted by the candidate at the time of
Counseling itself otherwise chance will be given to next candidate in order of
merit.
10. The candidates claiming reservation should bring Caste Certificate and
Income Certificate in original.
11. Candidates must write Name and address with phone number on backside of
the demand draft. Candidate must mentioned the name of course on top of
the envelop Speed Post.
12. Application form must be submitted by Speed Post only along-with demand
draft of Rs 800/- for General/OBC Candidate and Rs 400 for SC/ST Candidate in
favour of Finance Officer, University of Lucknow, Lucknow payable at Lucknow
Xerox copies of certificates/Mark Sheets and Two Self addressed Envelops
size (27x12cm) duly stamped with Rs. 30/-. No application form shall be
accepted by hand.
13. University reserves the right to cancel any admission at any stage.
14. In case of any matter relating to MCA admission 2014, the decision of the
Vice-Chancellor/Head, Deptt. of Computer Science, University of Lucknow
shall be final.
The address of correspondence will be

Head,
Office of Admissions M.C.A. Program 2014-15
Department of Computer Science,
University of Lucknow,
Lucknow-226007
Phone No. 0522-2742827
Mobile No: 9919766604



pg. 5



Check List:

1. Two Self addressed Envelops size (27x12cm) duly stamped with Rs.30/- ( )
2. High School/Equivalent Mark sheet ( )
3. High School/Equivalent Certificate ( )
4. Intermediate Mark sheet ( )
5. Intermediate Certificate ( )
6. Graduation (all Semester/year wise) Mark sheets ( )
7. Weightage Certificate as per item no. 9 given in the Form ( )
8. Draft of requisite amount of admission process fee Rs 800 /- for General/OBC
Candidate and Rs 400/- for SC/ST Candidate ( )
9. Professional (Specify) ( )
10. . ( )
11. . ( )

Number of enclosed documents ( ) ( )
In numbers In words

Ensure that:

The Xerox copy of the properly filled Application Form is procured or not ( )
The Postal receipt is procured or not ( )





(Signature of the Candidate)
Name of Candidate :
Mobile No. :
E-mail :