Vardhman

VARDHAMAN MAHAVEER OPEN UNIVERSITY, KOTA
ADMISSION FORM
(Formerly Kota Open University, Kota)
Serial No.
RAWATBHATA ROAD, KOTA (RAJ.) 324021
APPLICATION FORM FOR ADMISSION

SESSION JANUARY / JULY 20___
Application No.
(Please fill according to Guidelines attached)

1. Scholar No.
PHOTOGRAPH
(For office use only)
(Leave Blank)
Affix your latest passport size
photograph
2. Programme Code
3. Regional Centre
4.Study Centre Code
5. Date of Birth
(Attach Certificate)
SIGNATURE
(DD/MM/YYYY)
Put your Signature within the

box given below
6. FEE DETAILS
Bank TR/JR No.
TR/JR No.Date
Amount*
(Including Late Fee)
Issuing Bank
*Rs. 100/- Extra (Admission form charges) for downloaded/Emailed form
7. Name of Applicant (Leave one empty box between First Name, Middle Name and Surname)
8. Fathers Name of Applicant
9. Mothers Name of Applicant
10. Address for Correspondence (Leave one empty box between each unit of Address like House No., Street Name, Post etc.)
11. Tehsil
12. District
13. State
14. Pin Code
16. Medium of Study

1 - English
2 - Hindi
17. Gender
1 - Male
2 - Female
3 - Third Gender
22. Religion
18. Category
1 - General 4 - OBC
2 - SC
5 - SBC
3 - ST
6 - Any other
15. Mobile No. (for SMS Alerts)
19. Domicile
1 - Urban
2 - Rural
23. Special Category
1 - Hindu 4 - Christian 7- Parsi

2 - Muslim 5 - Jain
8 - Jews
3 - Sikh
6 - Budhist 9 - Others
1 - Ex-Serviceman
4 - Not applicable
2 - Kashmiri Migrant
3 - War-Widow
20. Nationality
1 - Indian
2 - Others
24. Marital Status

1 - Married
4 - Divorcee
2 - Unmarried
3 - Widow
21. Person with Disability

1 - Loco motor 4 Mental Retardation
2 - Low Vision 5 Mental Illness
3 - Hearing
6 Multiple Disability
25. Employment Status

1 - Employed
2 - Unemployed
3 - VMOU Employee/Wards
26. SUBJECT OPTION :

B.A./B.Com. Students are required to fill in three optional (elective) subjects. B.Sc. students are required to select any one of the optional (elective) subject
group. B.Ed. students are required to select any one of the optional (elective) subject group. B.Ed. students are required to select any two optional (Teaching)
subject. Refer to the prospectus for details.
1.
_________________________________________________________________________________________________
2.
_________________________________________________________________________________________________
3.
_________________________________________________________________________________________________
27.COURSE OPTION :
Write the Course Code and Credit in relevant box. Refer to the prospectus for details.
S.No.
Course Code
Credit
S.No.
10
11
12
13
14
Course Code
Credit
28. Relevant Qualifications (Which makes you eligible for the programme)
EXAMINATION PASSED
th
01 - Middle/8
02 - Matriculation/SSC/10th
03 - Intermediate/HSC/10+2/Equivalent
04 - Diploma in Engineering
05 - Graduation in Engineering
06 - Graduation (Three Year Degree)
07 - Post Graduation in Engineering
08 09 10 11 -
Board/University
Year of Passing
Marks Obtained
Total Marks
Percentage
Subjects (Leave one box empty between each subject)
Post Graduation or Equivalent

MBBS/BHMS/BAMS/BPT/B.Sc.Nursing
BAP/BCP/BSCP from VMOU
No formal Qualification but have
attained 18 years of age
29. Experience in related field
Division/Grade
(In years)
30. Declaration by Applicant
DECLARATION BY APPLICANT
I hereby declare that I have read and understood the conditions of eligibility for the programme for which I seek admission. I fulfill the minimum eligibility
criteria and I have provided necessary information in this regard. In the event of any information being found incorrect or misleading, my candidature shall be
liable to cancellation by the University at any time and I shall not be entitled to refund of any fee paid by me to the University. Further, I have carefully read and
understood the rules of the University as printed in the Prospectus and I accept them and shall not raise any dispute in the future over the same rule.
Date :__________________
Place :__________________
Full Signature of the Applicant
Checklist (Please tick in relevant box)

Photograph and self signature in appropriate Box
Challan for Programme fee with Name & Form No. overleaf
Attested Certificates and Mark sheets of relevant qualifications
Age Certificate
Experience Certificate (Wherever Applicable)
Category Certificate
Physically Handicapped Certificate
Widow/Divorcee Certificate
Ex-Service man/Kashmir migrant/War widow Certificate
Examination form
MBA student should attach entrance test score card
For office use only

Form checked, found Eligible/Not Eligible for Admission.
Signature :
Emp. Code :
Dealing Assistant
Section Officer
Regional Director
VARDHAMAN MAHAVEER OPEN UNIVERSITY, KOTA
EXAMINATION FORM
(Formerly Kota Open University, Kota)
Serial No.
EXAMINATION SECTION
RAWATBHATA ROAD, KOTA (RAJ.) 324021
Control No.
Term End Examination June / December 20____

INSTRUCTIONS
Fill up separate form for due papers/courses of various Examinations.
Write in CAPITAL LETTERS only within the box. Please read carefully the instructions given overleaf before filling up the form.
1. Scholar No.
PHOTOGRAPH
Affix your latest passport size
photograph
(New admission leave blank)

2. Programme Code
++++++++++
SIGNATURE
3. Regional Centre Code
4. Study Centre Code

Put your Signature within the
box given below
5. Examination Centre City

(Fill your Choice)
6. Medium of Examination
(HINDI/ENGLISH/Any other permitted language)
7. Examination Centre Code
(Leave Blank, To be allotted by Examination Section)
8. Name of the Candidate (Leave one empty box between First Name, Middle Name and Surname)
9. Address for Correspondence (Leave one empty box between each unit of Address like House No., Street Name, Post etc.)
10. City
11. District
12. State
13. Pin Code
14. Mobile No. (for SMS Alerts)
15. COURSE OPTION :

Course Codes for which appearing for the first time or failed in the earlier TEE including Practical Courses. Examination fee schedule and Instructions are given overleaf. A
Student shall not be allowed to appear in an examination for more than 54 Credits in Bachelors Degree Programme(s) and 56 Credits in Master Degree Programme (s).
Fees will be deposited in account of VARDHAMAN MAHAVEER OPEN UNIVERSITY, KOTA.
S.No.
Course Code
Credit
S.No.
10
11
12
13
14
Course Code
Credit
16. FEE DETAILS (Only to be paid by defaulter students for Due Papers)
Total No. of Courses
Bank TR/JR No.
TR/JR No. Date
/
Challan Amount
\
Issuing Bank
Amount Rs.
Theory Courses
Practical Courses
X
LATE FEE
TOTAL FEE
DETAILS FOR SUBMISSION OF EXAMINATION FORM

Students
For JUNE TEE*
FEE
For DECEMBER TEE*
FEE
WHERE TO SUBMIT
Regular
Defaulter
With Admission Form

1 April to 30 April
1 May to 10 May
Nil
Without Late Fee
With Late Fee
With Admission Form

1 October to 31 October
1 November to 10 November
Nil
Without Late Fee
With Late Fee
Concerned Regional Centre

Controller of Examination, VMOU,
Rawat Bhata Road, Kota 324021 (Raj.)
*Term End Examination
SCHEDULE OF EXAMINATION FEE

PROGRAMMES
BAP/BCP/BScP
Certificate
Diploma
Bachelor Degree
P.G. Diploma
Master Degree
Management
FEE
LATE FEE
100/- (Per Course/Paper)
EXAMINATION CENTRES
RC Code
Regional Centre
1
2
3
AJMER
BIKANER
JAIPUR
City
Ajmer, Bhilwara, Niwai, Beawer

Bikaner, Suratgarh*, Sriganganagar, Hanumangarh
Jaipur,Itarna (Alwar)*, Dausa, Rajgarh, Dholpur,
Jhunjhunu, Sikar, Alwar, Neem Ka Thana, Bharatpur, Kotputli, Chomu
4
JODHPUR
Jodhpur, Barmer , Pali, Falna, Jaiselmer, Jalor, Balotra, Sirohi
5
KOTA
Kota, Bundi, Baran, Sawai Madhopur, Chhabra, Jhalawar, Karauli
6
UDAIPUR
Udaipur, Dungarpur, Banswara, Nathdwara, Pratapgarh, Chittorgarh, Sajjangarh
*Exam Centre Suratgarh and Itarna (Alwar) is reserved for Defence personnel and their dependents
*DLIS & BLIS Exam will be held at scheduled Exam centers under concerned Regional Centre
INSTRUCTIONS FOR FILLING UP THE EXAMINATION FORM

1.
2.
3.
4.
5.
6.
7.
8.
Please write correct course code(s) as indicated in Prospectus, failing which the course(s) will not be included in the Permission Letter and Hall Ticket for
appearing in Examination.
In case wrong/invalid course code is mentioned in examination form, the course will not be included in the Permission letter and Hall Ticket and the
examination fee will not be refunded.
Defaulter student should fill separate form for Due papers of various Examination.
Please send the examination form by Registered/Speed Post and retain the proof of its mailing till you receive the Hall Ticket.
Term End Examination result is also available on the University website (www.vmou.ac.in or www.vmouonline.in). Please see the result status before filling
examination form.
It is advised to enclose/forward only the Examination Fee along with this form. Any other fee forwarded with this form will result in rejection of the
examination form.
Examination form received without examination fee or late fee (if applicable) will similarly be rejected.
A Student shall not be allowed to appear in an examination for more than 54 Credits in Bachelors Degree Programme and 56 Credits in Master Degree
Programme.
9. Fees will be deposited in the account of VARDHAMAN MAHAVEER OPEN UNIVERSITY, KOTA.
10. Examination Permission letter/Hall Ticket should be downloaded from the University website, One week before the commencement of examination.
Student should report at the Examination Centre with VMOU Identity Card.
11. University reserves the right to change the Examination Centre.
12. Change of Examination Centre, once allotted is not permissible under any circumstances.
DECLARATION BY STUDENT
I hereby declare that I have read and understood the instructions given above. I also affirm that I shall submit all the required number of assignments as
applicable for the course(s) filled in the examination form and that my registration for the course(s) is valid and not time barred. If any of my statements is found
to be untrue, I shall have no claim for taking examination. I undertake that I shall abide by the rules and regulations of the University.
Date :__________________
Place :__________________
Checklist
Full Signature of the Student
(Please tick in relevant box)
Challan for Examination fee.

Photograph & Signature in appropriate box.
Full Signature with Date & Place in DECLARATION BOX.
For office use only

Form checked, found Eligible/Not Eligible for Term End Examination
Signature :
Emp. Code :
Dealing Assistant
Section Officer
Assistant Registrar
Guidelines for filling in the Application Form for Admission

(Deposit the fee through Challan Only, Demand Draft will not be entertained)
Please fill up the form in English only and submit the same, in person or by post along with copies of
attested certificates, to your Regional Centre, so as to reach on or before the prescribed last date.
Incomplete application form and those received after the last date will be rejected.
Here are some specific instructions that will help you in filling in the application form. The instructions
are aimed at getting correct and accurate information from you so that you do not face problems
while filling it.
Instructions for filling in of Admission Application Form:1. Leave this column blank. Scholar number will be filled in by the University Office.
2.
For the programme code of the selected programme, refer to the relevant pages of your
prospectus.
3.
Fill the name of the nearest Regional Centre, refer to the prospectus.
4.
5.
Fill the study centre code of the selected Regional centre, refer to the prospectus.
Fill your date of Birth in given format i.e. DD/MM/YY
1 2 /
6.
7.
9 8 7
To fill your name see the correct format: for example, if your name is Kaushal Sharma then
write each alphabet separately in CAPITAL LETTERS in the box provided for and leave a
gap for clarity.
U
M A
Please write your Fathers name in CAPITAL LETTERS . Married women are also required
to write their Fathers name. For example if the Fathers name is Jagdish Prasad Sharma,
then write it in the following format:
J A G D I
9.
Fill your relevant fee details (JR/TR no.; JR/TR No. Date; Issuing Bank; amount)
K A
8.
0 5 /
S H
P A R S A D
S H A R M A
Please write Mothers name in English in the boxes in the format mentioned above in the
similar way. Use only CAPITAL LETTERS.
10. Fill in your address for correspondence where you would like to receive your study material
and all other letters. Do not repeat your name and fathers name here.
11. Fill the name of your City.
12. Fill the name of your District.
13. Fill the name of your State.
14. Fill in the correct Pin Code.
15. Fill your 10 digit mobile number.
130
16. For serial number 16-25 fill the relevant numeric code in the box. For example for English
write 1 and for Hindi write 2.(follow the same for all)
26. Students of B.A./B.Com./B.Sc. are required to fill in three optional (elective) subjects. B.A./
B.Sc. Students are required to select as per the optional (elective) subject groups. B.Ed.
students are required to select any 2 optional teaching subject
27. The candidate should fill up the relevant Course Code and Credit in the relevant box.
Refer to the prospectus for details
28. Please fill in relevant numeric code of the highest examination passed and fill the details of
required information of the examination passed. Please attach relevant Photocopies (duly
attested) of the mark sheet pertaining to Secondary, Senior Secondary and Graduation/ Post
Graduation whichever is applicable.
29. Fill in the relevant detail (wherever it is applicable) of experience.
30. Declaration by the Applicant should be filled and signed by the applicant himself/herself with
date and place.
Checklist: Before submission of form, check the whole form and tick all the attached documents.
Checklist (Please tick d
c in relevant box)
Photograph and self signature in appropriate Box

Challan for Programme fee with Name & Form No. overleaf
Attested Certificates and Mark sheets of relevant qualifications
Age Certificate
Experience Certificate (Wherever applicable)
Category Certificate
Physically Handicapped Certificate
Widow/Divorcee Certificate
Ex-Service man/Kashmir migrant/War widow Certificate
Examination form
MBA student should attach entrance test score card
131

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S H A R M A

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133
Axis Bank
Axis Bank
Axis Bank
Branch......................................
Branch......................................
Branch......................................
A/C No. :913020025097530
A/C No. :913020025097530
A/C No. :913020025097530
First Copy - Student Copy
Vardhaman Mahaveer Open University, Kota
Second Copy - University Copy
Rawatbhata Road, Kota-324021

Session: January/July 201....
Regional Centre of Student (Please Tick) : Jaipur/Ajmer/Jodhpur/Udaipur/Bikaner/Kota
Third Copy - Bank Copy


1.Programme Name
1.Programme Name
1.Programme Name
2.Student Name
2.Student Name
2.Student Name
3.Father's Name
3.Father's Name
3.Father's Name
4.Address
4.Address
4.Address
5.Fees Amount
Fees Detail
(a)Course Fee
(b)Exam Fee
(c)Late Fee
(d)Prat. Exam Fee
(e)Other Fee
Total Fees
Rs. ........Words............................
5.Fees Amount
Fees Detail
(a)Course Fee
(b)Exam Fee
(c)Late Fee
(d)Prat. Exam Fee
(e)Other Fee
Total Fees
Rs. ........Words............................
5.Fees Amount
Fees Detail
(a)Course Fee
(b)Exam Fee
(c)Late Fee
(d)Prat. Exam Fee
(e)Other Fee
Total Fees
6.Scholar No.
6.Scholar No.
6.Scholar No.
7.Mobile No.
7.Mobile No.
7.Mobile No.
TR/JR No. of Bank
TR/JR No. of Bank
Bank Stamp
Date
Note:- 1. Student can deposit the programme fee in any of the bank
branches in Rajasthan.
2. Fee once deposited will not be refunded.
Date
TR/JR No. of Bank
Bank Stamp
Signature of Student
Rs. ........Words............................
Bank Stamp
Date
Oriental Bank of Commerce
Branch......................................
Branch......................................

Branch......................................



1.Programme Name
1.Programme Name
1.Programme Name
2.Student Name
2.Student Name
2.Student Name
3.Father's Name
3.Father's Name
3.Father's Name
4.Address
4.Address
4.Address
5.Fees Amount
Fees Detail
(a)Course Fee
(b)Exam Fee
(c)Late Fee
(d)Prat. Exam Fee
(e)Other Fee
Total Fees
Rs. ........Words............................
5.Fees Amount
Fees Detail
(a)Course Fee
(b)Exam Fee
(c)Late Fee
(d)Prat. Exam Fee
(e)Other Fee
Total Fees
Rs. ........Words............................
5.Fees Amount
Fees Detail
(a)Course Fee
(b)Exam Fee
(c)Late Fee
(d)Prat. Exam Fee
(e)Other Fee
Total Fees
6.Scholar No.
6.Scholar No.
6.Scholar No.
7.Mobile No.
7.Mobile No.
7.Mobile No.
TR/JR No. of Bank
TR/JR No. of Bank
Bank Stamp
Date
Date
TR/JR No. of Bank
Bank Stamp
Rs. ........Words............................
Bank Stamp
Date
State Bank of Bikaner & Jaipur
Branch: ..............................
Branch: ..............................
Branch: ..............................
A/C No. : 61187836446
A/C No. : 61187836446
A/C No. : 61187836446




1.Programme Name
1.Programme Name
1.Programme Name
2.Student Name
2.Student Name
2.Student Name
3.Father's Name
3.Father's Name
3.Father's Name
4.Address
4.Address
4.Address
5.Fees Amount
Fees Detail
(a)Course Fee
(b)Exam Fee
(c)Late Fee
(d)Prat. Exam Fee
(e)Other Fee
Total Fees
Rs. ........Words............................
5.Fees Amount
Fees Detail
(a)Course Fee
(b)Exam Fee
(c)Late Fee
(d)Prat. Exam Fee
(e)Other Fee
Total Fees
Rs. ........Words............................
5.Fees Amount
Fees Detail
(a)Course Fee
(b)Exam Fee
(c)Late Fee
(d)Prat. Exam Fee
(e)Other Fee
Total Fees
6.Scholar No.
6.Scholar No.
6.Scholar No.
7.Mobile No.
7.Mobile No.
7.Mobile No.
TR/JR No. of Bank
TR/JR No. of Bank
Bank Stamp
Date
Date
TR/JR No. of Bank
Bank Stamp
Rs. ........Words............................
Bank Stamp
Date

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VARDHAMAN MAHAVEER OPEN UNIVERSITY, KOTA

(Formerly Kota Open University, Kota)

RAWATBHATA ROAD, KOTA (RAJ.) 324021

APPLICATION FORM FOR ADMISSION

(Please fill according to Guidelines attached)

(For office use only)

4.Study Centre Code

Put your Signature within the

(Including Late Fee)

8. Fathers Name of Applicant

9. Mothers Name of Applicant

14. Pin Code

16. Medium of Study

15. Mobile No. (for SMS Alerts)

23. Special Category

1 - Hindu 4 - Christian 7- Parsi

24. Marital Status

21. Person with Disability

25. Employment Status

26. SUBJECT OPTION :

Subjects (Leave one box empty between each subject)

Post Graduation or Equivalent

29. Experience in related field

30. Declaration by Applicant

Full Signature of the Applicant

Checklist (Please tick in relevant box)

For office use only

VARDHAMAN MAHAVEER OPEN UNIVERSITY, KOTA

(Formerly Kota Open University, Kota)

Term End Examination June / December 20____

(New admission leave blank)

4. Study Centre Code

5. Examination Centre City

(HINDI/ENGLISH/Any other permitted language)

7. Examination Centre Code

(Leave Blank, To be allotted by Examination Section)

13. Pin Code

14. Mobile No. (for SMS Alerts)

15. COURSE OPTION :

Bank TR/JR No.

TR/JR No. Date

DETAILS FOR SUBMISSION OF EXAMINATION FORM

For JUNE TEE*

For DECEMBER TEE*

With Admission Form

With Admission Form

Concerned Regional Centre

*Term End Examination

SCHEDULE OF EXAMINATION FEE

100/- (Per Course/Paper)

100/- (Per Course/Paper)

150/- (Per Course/Paper)

150/- (Per Course/Paper)

Ajmer, Bhilwara, Niwai, Beawer

INSTRUCTIONS FOR FILLING UP THE EXAMINATION FORM

Full Signature of the Student

(Please tick in relevant box)

Challan for Examination fee.