Scribd Logo
Upload

Welcome to Scribd!

  • 121 views

    Jain University New

    Uploaded by

    sudhakar kethana
    This document contains an enrollment form for a distance learning university. It requests personal information like name, date of birth, contact details, as well as education history and documents. The form has sections for communication addresses, education details listing past exams and results, work experience, and a signature agreeing to the information provided. It collects all relevant applicant information needed for enrollment in distance education courses.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Jain University New

    Uploaded by

    sudhakar kethana
    121 views2 pages
    This document contains an enrollment form for a distance learning university. It requests personal information like name, date of birth, contact details, as well as education history and documents. The form has sections for communication addresses, education details listing past exams and results, work experience, and a signature agreeing to the information provided. It collects all relevant applicant information needed for enrollment in distance education courses.

    Original Description:

    SDSS

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document contains an enrollment form for a distance learning university. It requests personal information like name, date of birth, contact details, as well as education history and documents. The form has sections for communication addresses, education details listing past exams and results, work experience, and a signature agreeing to the information provided. It collects all relevant applicant information needed for enrollment in distance education courses.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    121 views2 pages

    Jain University New

    Uploaded by

    sudhakar kethana
    This document contains an enrollment form for a distance learning university. It requests personal information like name, date of birth, contact details, as well as education history and documents. The form has sections for communication addresses, education details listing past exams and results, work experience, and a signature agreeing to the information provided. It collects all relevant applicant information needed for enrollment in distance education courses.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Directorate of Distance Education

    Enrollment Information
    Code Unv. Enrollment No.
    Course Batch

    Personal Information

    First Name

    PHOTO
    Middle Name

    Surname

    Blood
    Gender  Male  Female Group
    Birth Date Birth Place
    Email Id Mobile No
    Secondary
    Aadhar Card No
    Mobile No
    Father/Husband Mother
    Name Name
    Physical
    Location  Rural  Urban  Disabled  Non-Disabled
    Status
    Marital
    Working Status  Employed  Un-Employed
    Status
    Mother
    Category
    Tongue
    Optional Second
    Language (For UG
    courses)

    Communication Information
    Correspondence Address Permanent Address  Same as Correspondence
    Address Line 1 Address Line 1
    Address Line 2 Address Line 2
    Country Country
    State State
    City City
    Pincode Pincode

    Document List
    Sr. No Document
    1 Date of Birth Proof (School Leaving Certificate or Transfer  Attested True Copy
    Certificate or Any Legally Accepted Certificate Of Date Of Birth)
    2 10th Mark Sheet  Attested True Copy
    3 12th Mark Sheet (Mandatory for UG & PG Course)  Attested True Copy
    4 Graduate Mark Sheet (Mandatory for PG Course)  Attested True Copy
    5 KYC document (like Aadhar Card, PAN, Voter ID etc.)  Attested True Copy
    Education Detail Section
    Name of Board/University &
    Exam Name Degree/Passing Certificate No
    School/College

    Date Of Passing(DD/MM/YYYY) Subject Studied Result

    Marks Obtained Maximum Marks Division

    Exam Certificat Passi Name of Subject Marks Max Division / Result Is Highest
    e No ng Board / s Obtained Marks Percentage
    Year Universit
    y

    Work Experience
    Company Name

    Off. Address Currently Working  Yes  No

    Date of Joining Date of Leaving

    Date: Candidate Signature

    You might also like