Examination Form 2021-2022

ijh{kk vkosnu i= 2021-2022

Regular fu;fer % ? Ex-student HkwriwoZ fo|kFkhZ %  Private Lok/;k;h % ?

Roll No. vuqØekad % Enroll./Reg. No. ukekadu@iaath;u dz-
Examination ijh{kk % _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Main Subject eq[; fo"k; % _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Other Subject(s) vU; fo"k; % _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_______________________________________________
Examination Centre ijh{kk dsUnz %
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _Affix
_ _ _ recent
__
passport size
Name of the Student (in English) (in block letters) : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ photograph
_______
ijh{kkFkhZ dk iwjk uke ¼fgUnh esa½ % _______________________________________________
IkkliksVZ vkdkj dk
Father’s/Husband’s Name firk@ifr dk uke %_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Nk;kfp=
_ _ _ _ _fpidk;s
__ a

Mother’s Name ekrk dk uke %_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Date of Birth tUefrfFk % _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Sex fyax %  Female efgyk  Medium ek/;e Hindi fgUnh  English vaxzsth 
Male iq#Ô
Mother tongue ekr`Hkk"kk % Religion /keZ %
Cast tkfr % lkekU; Gen v-fi-o- OBC  v-tk- SC  v-t-tk- ST 
AADHAR CARD NO             Nk;kizfr layXu djsaA
Address irk % _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Signature of the Student
_______________________________________________ ijh{kkFkhZ ds gLrk{kj
____________________________________________________
Pin code Phone/Mobile No.

For Office Use Only dk;kZy;hu dk;Z gsrq

Exam & other fee ijh{kk ,oa vU; 'kqYd Rs. _ _ _ _ _ Ref No. fnukad _ _ _ _ _ _ _ _ _ _ _ _ _ }kjk tek fd;k x;kA

Details of examination(s) passed mÙkh.kZ ijh{kkvksa dk fooj.k %

No. Name of Exam Roll No. Enrol./Reg. Board/University Yr Subject Marks Div.
Ø- ijh{kk dk uke vuqØekad No. cksMZ@fo’ofo|ky; oÔZ fo"k; Ob. Js.kh
ukeka-@iath- çkIrkad
Ø-

Details of other examination (conducted by the university) applied for fo’ofo|ky; }kjk lapkfyr vU; ijh{kk esa lfEefyr
gks jgs gksa rks ijh{kk dk uke _ _ _ _ _ _ _ _ _ _ Subject fo"k; _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
If charged for use of unfair means in the previous examination, give details. foxr ijh{kk esa vuqfpr lk/kuksa dk ç;ksx djrs
idM+s x;s gksa] rks mldk fooj.k nsa %&
Exam ijh{kk dk uke _ _ _ _ _ _ _ _ _ _ Year oÔZ _ _ _ _ _ _ _ _ Roll No. vuqØekad % _ _ _ _ _ _ _ _ _ Result ifj.kke _ _ _ _ _ _

Notification no. vf/klwpuk Øekad _ _ _ _ _ _ _ _ _ Date fnukad _ _ _ _ _ _ _ _ _ (enclose copy çfrfyfi layXu djsa½
 For REGULAR Student fu;fer ijh{kkFkhZ ds fy,
Attestation by the Class Teacher d{kk/;kid }kjk izek.khdj.k
I examined thoroughly the examination form of Shri/Smt./Ku. ……………………………………………………………………………………
and certify that the details given in application form are true. The attendance in the class is not less than 75% I know
nothing against the student’s character, which might debar him/her from the University Examination.
eSus Jh@Jherh@dqekjh ------------------------------------------------------------------------------------- ds vkosnu i= dh lE;d takp dj yh gS vkSj izekf.kr fd;k tkrk gS
fd vkosnu i= esa fn;s x;s fooj.k lR; gS A budh d{kk esa mifLFkfr 75% ls de ugha gS A eSa ijh{kkFkhZ ds pfj= ds fo"k; esa ,slk dqN Hkh
ugha tkurk@tkurh] ftlls mls fo’ofo|ky; dh ijh{kk esa izos’k ikus ls oafpr fd;k tk lds A

Date fnuakd % ----------------------- Signature of Class Teacher

d{kk/;kid ds gLrk{kj
&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
For REGULAR/PRIVATE/EX-Student fu;fer@Lok/;k;h@HkwriwoZ ijh{kkFkhZ ds fy;s
Attestation by the forwarding Authority vxzsÔ.kdrkZ vf/kdkjh dk izek.k i=
I examined thoroughly the examination form of Shri/Smt./Ku. ………………………………………………………………… appearing as
regular/Private student in class ………………………………………… Subject ……………………………………………… . All statements given in
the application form are true to the best of my knowledge and belief. His/her examination form is forwarded alongwith
the photocopies of original mark sheets and certificates of qualifying examinations.
eSus Jh@Jherh@dqekjh ------------------------------------------------------------------------------------- tks fu;fer@Lok/;k;h ijh{kkFkhZ ds
:i esa d{kk ------------------------------------ foÔ; ------------------------------ dh ijh{kk esa lfEefyr gks jgs@jgh gSa] ds vkosnu i= dh
lE;d takp dj yh gS A budk ijh{kk vkosnu i= vgZdkjh ijh{kk dh vadrkfydk ,oa izek.k i= dh Nk;kizfr;ksa ds lkFk vxzsfÔr gS A

Date fnuakd % ------------------------------- Signature of Principal/HOD with Seal

izkpk;Z@foHkkxizeq[k ds gLrk{kj ,oa eqgj
&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
For PRIVATE Student Lok/;k;h ijh{kkFkhZ ds fy;s
Declaration ?kksÔ.kk
I Shri/Smt./Ku. ………………………………………………………………… Presently not a bonafied student of any affiliated college. I
have not taken admission in any other college using the Migration Certificate issued by the IKS University. I hereby
declare that except this exam, I have not applied for any other examination conducted by this University or any other
University. I have not taken admission as regular student of this University or any affiliated college before 13 months
from the commencement of this examination. I also declare that all statements made in the application are true to the
best of my knowledge and belief. I am aware that my application can be rejected if the informations given by me are
incomplete or incorrect and I am liable to be punished as per rule. All the required documents are attached.
eSa Jh@Jherh@dqekjh ------------------------------------------------------------------------------------- orZeku esa fdlh Hkh lEc) egkfo|ky;
dk Nk=@Nk=k ugha gWwa A eSus bafnjk dyk laxhr fo’ofo|ky; ls izotu izek.k i= ysdj fdlh vU; egkfo|ky; esa izos’k ugha fy;k gSA eSa ?kks"k.kk
djrk@djrh gWwa fd vkosnu i= esa n’kkZ;h xbZ ijh{kk ds vfrfjDr bl fo’ofo|ky; vFkok fdlh vU; fo’ofo|ky; dh ijh{kk esa vkosnu ugha
fd;k gSA eSa bl ijh{kk ds izkjaHk gksus ds 13 ekg iwoZ ls fdlh egkfo|ky; esa fu;fer Nk=@Nk=k ugha jgk@jgh gWwa A eSa ;g ?kks"k.kk djrk@djrh
gWwa fd vkosnu i= esa fn;s x;s fooj.k esjh tkudkjh vkSj fo’okl ds vuqlkj lR; gS A eq>s Kkr gS fd nh xbZ lwpukvksa ds viw.kZ vkSj vlR;
ik;s tkus ij esjk vkosnu i= fujLr fd;k tk ldrk gS vkSj eSa fo’ofo|ky; ds fu;ekuqlkj n.M dk Hkkxh gksÅaxk@gksÅaxh A ijh{kk dh ik=rk
laca/kh vadlwph vkfn leLr izek.k i= bl vkosnu ds lkFk layXu dj fn;s gSa A

Date fnuakd % ------------------------------ Signature of Student

ijh{kkFkhZ ds gLrk{kj
&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
Character Certificate pfj= izek.k i=
I know nothing against the student’s character, which might debar him/her from the University Examination.
eSa ijh{kkFkhZ ds pfj= ds foÔ; esa ,slk dqN Hkh ugha tkurk@tkurh] ftlls mls fo’ofo|ky; dh ijh{kk esa izos’k ikus ls oafpr fd;k tk lds A

Date fnuakd % -------------------------------------- Signature of Gazetted Officer with Seal

jktif=r vf/kdkjh ds gLrk{kj ,oa eqgj
&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
For Office use only fo’ofo|ky; dk;kZy; gsrq

After Verification the examination form is found  complete & forwarded  incomplete & not forwarded.

Signature of Incharge Examination

 GUIDELINES FOR FILLING IN THE APPLICATION FORM
vkosnu i= dh iwfrZ laca/kh funsZ’k
1. Read the following Instructions and fill them carefully in own handwiting. Wrong & incomplete forms will
not be accepted under any circumstances.

fuEufyf[kr funsZ’kksa dks i<+dj viuh gLrfyfi esa vkosnu i= lko/kkuhiwoZd HkjsaA =`[email protected] vkosnu i= fdlh Hkh
ifjfLFkfr esa Lohdkj ugha fd, tk;saxsA
2. Filled Examination and Registration form should be forwarded to University through the HOD/Principal of
any affiliated college/Centre.
Hkjs gq, ijh{kk vkosnu i= vkSj iathdj.k i= dks foHkkx izeq[k@fdlh lac) egkfo|ky;@dsUnz ds izkpk;Z }kjk fo’ofo|ky;
dks izsfÔr djk,aA
3. Confirm whether the syllabus and the subject applied for the examination are available in the University.
Apply only for those subjects or which affiliation/recognition is granted to the concerned center.
lqfuf'pr dhft;s fd ijh{kk gsrq p;fur foÔ; vkSj ikB~;dze fo’ofo|ky; esa miyC/k gS A mUgha foÔ;ksa ds fy, vkosnu djsa]
ftuds fy, lacaf/kr ijh{kk dsUnz dks ekU;rk@lac)rk iznku dh xbZ gSA
4. Attach all the required documents dully attested by the Gazetted Officer.
lHkh vko’;d nLrkost jktif=r vf/kdkjh }kjk izekf.kr djokdj vfuok;Z :i ls layXu djsaA
5. In case, change of name/surname, an affidavit by class-I Magistrate should be enclosed alongwith the fee of
980.00 for the same.
uke ifjorZu dh n’kk esa izFke Js.kh eftLVsªV ds le{k 'kiFk i= layXu djsa vkSj vkosnu ds lkFk uke ifjorZu 'kqYd :-
980-00 vyx ls tek djsaA
6. In case wrong and false information found in the form, the student will be disqualified and the result will be
cancelled.
vkosnu i= esa =qfViw.kZ ,oa vlR; lwpuk,a ik, tkus ij ijh{kkFkhZ v;ksX; ekuk tkosxk vkSj ijh{kkQy fujLr dj fn;k
tkosxkA
7. Application form alongwith the examination fee should reach the University on or before the prescribed dates.
ijh{kk 'kqYd ds lkFk vkosnu i= fu/kkZfjr frfFk rd ;k mlds iwoZ fo’ofo|ky; esa igqapuk vfuok;Z gSA
8. Change of examination center is not allowed after submitting the form. But University may consider under
special circumstances for which a fee of Rs. 1770.00 should be paid separately.
vkosnu i= tek gksus ds i'pkr ijh{kk dsUnz esa ifjorZu dh vuqefr ugha gS] ysfdu fo’ofo|ky; dks fo’ksÔ ifjfLFkfr;ksa esa
,slk djus dk vf/kdkj gS] ,slh n’kk esa ijh{kkFkhZ dks ijh{kk frfFk ls 45 fnu iwoZ :- 1770-00 ijh{kk dsUnz ifjorZu ds :i
esa Hkqxrku vyx ls djuk gksxkA
9. Examination fees alongwith the form should be paid as per the fee chart through RTGS/NEFT favour of
Registrar, Indira Kala Sangeet Vishwavidyalaya, Khairagarh payable at Bank of Maharashtra, Khairagarh,
Account No. 20215300558 (Branch Code MAHB 0001103)
vkosnu i= ds lkFk fooj.kkuqlkj ijh{kk ’kqRd dqylfpo] bafnjk dyk laxhr fo’ofo|ky;] [kSjkx<+ ds i{k esa cSad vkWQ
egkjk"Vª dh [kSjkx<+ 'kk[kk ds [kkrk dz- 20215300558 ¼dksM la[;k& MAHA 0001103½ esa RTGS/NEFT ds ek/;e ls
tek djsaA
10. Student should collect the admit card from their concerned centers one week before the commencement of
examination. Contact the concerned center for information regarding practical examination. Mark list and
certificates will be sent to the centers, students are to be collected from the concerned centers only.
ijh{kk izkjaHk gksus ls ,d lIrkg iwoZ viuk izos’k i= vius ijh{kk dsUnz ls gh izkIr djsa A izk;ksfxd ijh{kk ds fy;s vius
ijh{kk dsUnz ls lEidZ djsa A vadrkfydk vkSj izek.k i= lh/ks ijh{kk dsUnz dks Hkstsa tk;saxs A ijh{kkFkhZ bUgsa dsUnz ls gh izkIr
djsaA
 Annual Examination Fee For Private Students 2021-22
Lok/;k;h ijh{kkfFkZ;ksa ds fy, okf”kZd ijh{kk ‘kqYd 2021&22
Ø- ijh{kk dk uke ijh{kk vadlwph vkosnu izek.k vfrfjD ukekadu dqy ;ksx
'kqYd 'kqYd izfØ;k i=@ r ‘kqYd @iath; 10 ds
'kqYd mikf/k u ‘kqYd xq.kkad esa
'kqYd
1
izFkek izFke o"kZ Prathama First Year 780 310 390 0 480 390 2350
2
izFkek vafre o"kZ Prathama Final Year 780 310 390 390 480 390 2740
3
e/;ek izFke o"kZ Madhyama First Year 840 310 390 0 480 390 2410
4
e/;ek vafre o"kZ Madhyama Final 840 310 390 390 480 390 2800
Year
5
fon izFke o"kZ Vid First Year 980 310 390 0 480 390 2550
6
fon vafre o"kZ Vid Final Year 980 310 390 390 480 390 2940
7
dksfon izFke o"kZ Kovid First Year 1010 310 390 0 480 390 2580
8
dksfon vafre o"kZ Kovid Final Year 1010 310 390 390 480 390 2970
9
xhraktyh twfu;j fMIyksek Geetanjali Jr. 840 310 390 390 480 390 2800
Diploma
10
xhraktyh lhfu;j fMIyksek Geetanjali 840 310 390 390 480 390 2800
Sr.Diploma
11
,d o"khZ; yksd laxhr fMIyksek 840 310 390 390 480 390 2800
One Year Folk Music Diploma
12
f}&o"khZ; yksd laxhr fMIyksek izFke o"kZ 840 310 390 0 480 390 2410
Two Years Folk Music Diploma First Yaer
13
f}& o"khZ; yksd laxhr fMIyksek vafre o"kZ 840 310 390 390 480 390 2800
Two Year Folk Music Diploma Final Yaer
14 f}&o"khZ; vkVZ ,fizfl;s’ku dkslZ izFke o"kZ 2350 310 390 0 480 390 3920
Two Years Diploma Programme of Art
Appreciation Course in Painting
15 f}&o"khZ; vkVZ ,fizfl;s’ku dkslZ fMIyksek dk;Zdze 2350 310 390 390 480 390 4310
vafre o"kZ
Two Years Diploma Programme of Art
Appreciation Course in Painting Final Year
16 ,e-,- izFke o"kZ ¼laxhr@u`R;@yksdlaxhr½ 1190 390 390 0 480 390 2840
M.A.Final Year Music/Dance/Folk Music
17 ,e-,- vafre o"kZ ¼laxhr@u`R;@yksdlaxhr½ 1190 390 390 1150 480 390 4150
M.A.Final Year Music/Dance/Folk Music

Vhi%&
1- fcuk foyEc ‘kqYd fnukad 20-12-2021
2- foyEc ’kqYd fnukad 27-12-2021 fMIyksek :- 520-00 Lukrd ,oa LukrdksRrj :- 640-00
3- fo’ks”k vuqefr ‘kqYd 6490-00 fnukad 03-01-2022
4- uke ifjorZu ’kqYd :- 980-00
5- bfexzs’ku ’kqYd :- 980-00
6- ijh{kk dsUnz ifjorZu ‘kqYd :- 1770-00 ,oa lacaf/kr izkpk;Z ls fyf[kr vuqefr ds i’pkr~A
7- ,e-,- izFke o”kZ ds ijh{kk vkosnu i= fcuk ekbxzs’ku ds Lohdkj ugha fd;k tk;sxkA
8- lHkh fo|kFkhZ viuk ijh{kk vkosnu i= vius ijh{kk dsUnz ls vxzsf”kr djokdj gh HkstsaA dksbZ Hkh ijh{kk vkosnu lh/ks
fo’ofo|ky; esa Lohdkj ugha fd;k tk;sxkA
 Annual Examination Fee For Regular Students 2021-22
fu;fer ijh{kkfFkZ;ksa ds fy, ijh{kk ‘kqYd 2021&22
Ø- ijh{kk dk uke ijh{kk vadlwph vkosnu izfØ;k izek.k i=@ dqy ;ksx
'kqYd 'kqYd 'kqYd mikf/k 'kqYd 10 ds xq.kkad esa
1
izFkek izFke o"kZ Prathama First 580 310 390 0 1280
Year
2
izFkek vafre o"kZ Prathama Final 580 310 390 390 1670
Year
3
e/;ek izFke o"kZ Madhyama First 730 310 390 0 1430
Year
4
e/;ek vafre o"kZ Madhyama Final 730 310 390 390 1820
Year
5
fon izFke o"kZ Vid First Year 780 310 390 0 1480
6
fon vafre o"kZ Vid Final Year 780 310 390 390 1870
7
dksfon izFke o"kZ Kovid First Year 980 310 390 0 1680
8
dksfon vafre o"kZ Kovid Final Year 980 310 390 2070
390
9
xhraktyh twfu;j fMIyksek Geetanjali Jr. 780 310 390 1870
Diploma 390
10
xhraktyh lhfu;j fMIyksek Geetanjali 780 310 390 1870
Sr.Diploma 390
11
,d o"khZ; yksd laxhr fMIyksek 730 310 390 1820
One Year Folk Music Diploma 390
12
f}&o"khZ; yksd laxhr fMIyksek izFke o"kZ 730 310 390 0 1430
Two Years Folk Music Diploma First Yaer
13
f}& o"khZ; yksd laxhr fMIyksek vafre 730 310 390 1820
o"kZ 390
Two Year Folk Music Diploma Final Yaer
14 f}&o"khZ; vkVZ ,fizfl;s’ku dkslZ izFke o"kZ 1900 310 390 2600
Two Years Diploma Programme of Art 0
Appreciation Course in Painting
15 f}&o"khZ; vkVZ ,fizfl;s’ku dkslZ fMIyksek 1900 310 390 2990
dk;Zdze vafre o"kZ 390
Two Years Diploma Programme of Art
Appreciation Course in Painting Final Year
16 ,d o”khZZ; fgUnh fMIyksek 730 310 390 1820
One Year Hindi Diploma 390
17 fMIyksek bu dE;wfudsfVo bafXy’k 730 310 390 1820
Diploma in Communicative English 390

Vhi%&
1- foyEc ‘kqYd fMIyksek gsrq :- 520-00 Lukrd@LukrdksRrj ikB~dze gsrq :- 640-00
Last Date for Diploma Rs. 520.00, UG/PG Course Rs. 640.00
2- fo’ks"k vuqefr ’kqYd :- 6490-00$foyEc ‘kqYd$ewy ijh{kk ‘kqYd
Spacial Permission Fee Rs. 6490.00+Late Fee+Exam Fee
3- uke ifjorZu ’kqYd :-980-00
Fee For Change of Name Rs. 980.00
4- bfexzs’ku ’kqYd :- 980-00
Immigration Fee Rs. 980.00
5. ijh{kk dsUnz ifjorZu ‘kqYd :- 1770-00
Change of Exam Centre Rs. 1770.00
5-

2- Indira Kala Sangit Vishwavidyalaya, Khairagarh (C.G.) 491881

ADMIT CARD
2021-22 Regular/Private/Ex-Student

Roll Number ……………… Enrol./Reg.No.----------------

Name of the Student ……………………………………………………………………………..

Father’s/Husband’s Name ……………………………………………………………………..
Name of Examination …………………………………………………………………………….
Subject (Main) …………………………………………………………………………
Other Subject……………........................................................................................
Permanent Add ………….............................................................................................
…………............................................Mobile No.-......................................
Examination Centre----------------------------------------------------------------------------

Medium Hindi  English 

Registrar
Indira Kala Sangeet Vishwavidyalaya
KHAIRAGARH (C.G.)
Signature of Student

INSTRUCTIONS

1. Examination hall will be opened half an hour before the scheduled time on the first day of
examination and 15 minutes before in the subsequent days.
2. Students are to be seated only in the allotted seats in the examination hall as per the Roll Numbers
mentioned.
3. Students are not allowed to keep any kind of study materials (Books, Notebooks, Slip, etc.) in
possession inside the Examination hall except the required materials for writing the examination. Cell
phone/Mobile Phone/Calculator etc. are prohibited in the examination hall.
4. No students will be allowed to enter the hall after half an hour from the commencement of the
examination.
5. Student will be responsible for any kind of misconduct in the examination hall.
6. Student should use only the provided answer books for writing. Any kind of usage of unfair means is
punishable.
7. Use both sides of the answer sheet for writing. To cancel any written answer, draw a line across the
page.
8. After distribution of the Question Paper student will not be permitted to leave the examination hall for
one hour. In case of any emergency, the Center Superintendent may allow the student to leave the
examination hall for a short while.
9. Before leaving the hall, students have to submit the answer books to the concerned authority.
10. After submitting the answer book entry to the hall is prohibited.
11. Student should bring the Admit Card on each examination and it should be produced on demand.
12. Student should sign in the specified place in the attendance sheet as instructed by the invigilator.
13. Name of such students will be deleted from the Roll List if any identical marks/sign/names etc. are
found in their answer books and they will be disqualified for any examination of the University.
14. Please ensure that you are eligible according to the eligibility criteria stipulated in the prospectus for
the course. If you are not eligible, your admission & examination will be cancelled any stage of the
processing. Please note that even if you pass in the examination & subsequently it is found that you do
not fulfill the eligibility criteria, your admission & examination will be cancelled.
***
 Indira Kala Sangit Vishwavidyalaya, Khairagarh (C.G.) 491881
ATTENDANCE SHEET
2021-22 Regular/Private/Ex-Student
Roll Number …………………
Enrol./Reg. No.-------------

Name of the Student …………………………………………………………………………..

Father’s/Husband’s Name …………………………………………………………………..
Name of Examination ………………………………………………………………………….
Subject (Main) …………………………………………………………………………………….
Other Subject……………....................................................................................................
Permanent Add …………....................................................................................................
…………............................................Mobile No.-..........................................................
Examination Centre----------------------------------------------------------------------------

Medium Hindi  English 

Registrar
Indira Kala Sangeet Vishwavidyalaya
Signature of Student KHAIRAGARH (C.G.)

Date of Exam. Time of Name of Subject/Paper Answer Sheet Sign. of Student Sign of Invigilator
Exam. Number