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Application Form: Candidate's Full Name

This document is an application form for admission to the Urdu Correspondence Course offered by the Arjun Singh Centre for Distance and Open Learning at Jamia Millia Islamia university. The form requests information such as the applicant's name, address, date of birth, category, nationality, mother tongue, Aadhar number, occupation, and contact details. It also provides instructions to submit a postal order or bank draft of Rs. 100 for Indian nationals or varying amounts for international applicants along with the completed form.

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Mohammad Vaqqas
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0% found this document useful (0 votes)
73 views1 page

Application Form: Candidate's Full Name

This document is an application form for admission to the Urdu Correspondence Course offered by the Arjun Singh Centre for Distance and Open Learning at Jamia Millia Islamia university. The form requests information such as the applicant's name, address, date of birth, category, nationality, mother tongue, Aadhar number, occupation, and contact details. It also provides instructions to submit a postal order or bank draft of Rs. 100 for Indian nationals or varying amounts for international applicants along with the completed form.

Uploaded by

Mohammad Vaqqas
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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To be filled in by the Office

Hindi/English Medium
Admission No.

APPLICATION FORM
Urdu Correspondence Course Affix your recent
Arjun Singh Centre for Distance and Open Learning Photograph
Jamia Millia Islamia
Jamia Nagar, New Delhi-110025

Candidate’s full name:

Father’s name:

Mother’s name:

Category: General Scheduled Caste Scheduled Tribe Physically Handicapped

Nationality ………………………… Mother Tongue……………………… Aadhar No. ……….….…........

Date of Birth: Date: Month: Year: Age:

Address: (i) Permanent Address:


………………………………………………………………………………………………………………
………………………………………………………………………………………… PIN ……………….

(ii) Mailing Address


………………………………………………………………………………………………………….……
………………………………………………………………………………………… PIN ……………….

Telephone No………………………………..Email………………………………………………………...
Present Occupation: …………………………………………………………………………………………..
Date……………………. Signature……………
(FOR OFFICE USE ONLY)
Received I.P.O./ Bank Draft No. ……………………..Dated…….……For Rs. …………………
As prescribed fee.
Dealing Assistant
Admitted and allotted
No …………………..

Admit and send teaching material Signature


Head

“Please send a Postal Order or a Bank Draft of Rs. 100/- (Rs. Hundred only) for Indian National, US $ 20 ( US Dollars Twenty only ) for Foreigners (SAARC
countries) and US $ 50 (US Dollars Fifty only) other Countries addressed to JAMIA MILLIA ISLAMIA, payable at NEW DELHI” along with this admission form
For detail please contact at: [email protected] Tel: 26981717 / 2845

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