B.A. Exam application.cdr - Karnataka State Open University

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KARNATAKA STATE OPEN UNIVERSITY
Mukthagangotri, Mysore - 570 006
EXAMINATION APPLICATION FOR FIRST/SECOND/THIRD YEAR B.A PROGRAMME
Month...............Year.........
Instructions : Entries must be filled by the candidates in** Capital Letters.
.
Single
Mark ( ) is for shading the appropriate circle completely. e.g -
Regulation : R1
R2
1.**Register Number
2.* Year of
Admission
-
I
-
II
-
III
3.*Name of the Examination Center
4.*Name of the Candidate (As per SSLC)
6.*Category
5.*Address of the Student for Correspondence (Do not write name again)
ST
SC
CAT-I
OBC
7.*Sex :
P.H
GM.
8.*B.A :
Male
Female
II
I
III
9. **Telephone Numbers (with STD code)
Residence
Mobile
0
+91
NOTE :- Subjects/Papers for which to appear - Please shade the appropriate circle in front of subject appearing for the Examination.
Second Year Examination
First Year Examination
If passed write
year & month
LANGUAGE (SELECT ANY TWO)
1. Kannada
2. English
3. Hindi
5. Sanskrit
6. Telugu
7. Tamil
4. Urdu
If passed write
year & month
LANGUAGE (SELECT ANY TWO)
1. Kannada
2. English
3. Hindi
5. Sanskrit
6. Telugu
7. Tamil
Compulsory Optional Subject : ICHR & ES
Compulsory Optional Subject : ICHR & ES
OPTIONAL SUBJECT (SELECT ANY THREE)
4. Urdu
1. Kannada
7. Education
1. Kannada
7. Education
2. English
8. Psychology
2. English
8. Psychology
3. History
9. Hindi
3. History
9. Hindi
4. Sociology
10. Urdu
4. Sociology
10. Urdu
5. Economics
11. Anthropology
5. Economics
11. Anthropology
6. a. Pol-Science
12.Geography
6. a. Pol-Science
12.Geography
b. Pub-Adminisration
b. Pub-Administration
(Select Any One)
(Select Any One)
BPP
Applies For Regulation I (R1) students only
Third Year Examination
If passed write
year & month
KANNADA (III)
URDU (III)
ECONOMICS (III)
EDUCATION (III)
GEOGRAPHY (III)
KANNADA (IV)
URDU (IV)
ECONOMICS (IV)
EDUCATION (IV)
GEOGRAPHY (IV)
KANNADA (V)
URDU (V)
ECONOMICS (V)
EDUCATION (V)
GEOGRAPHY (V)
ENGLISH (III)
HISTORY (III)
POL-SCIENCE (III)
PSYCHOLOGY (III)
ENGLISH (IV)
HISTORY (IV)
POL-SCIENCE (IV)
PSYCHOLOGY (IV)
ENGLISH (V)
HISTORY (V)
POL-SCIENCE (V)
PSYCHOLOGY (V)
HINDI (III)
SOCIOLOGY (III)
PUB-ADMN (III)
ANTHROPOLOGY(III)
HINDI (IV)
SOCIOLOGY (IV)
PUB-ADMN (IV)
ANTHROPOLOGY(IV)
HINDI (V)
SOCIOLOGY (V)
PUB-ADMN (V)
ANTHROPOLOGY(V)
11. Medium : Kannada / English
10. Sex: Male / Female
12. Year in which
BPP Exam Appeared / Not
Candidate completed
the Programme
II Year
I Year
III Year
13. Details of the fee paid :
Year
Amount Paid
Name of the Bank
Challan No.
Date
I Year
II Year
III Year
I declare that the above information furnished by me is correct to the best of my knowledge.
.............................................
Signature of the Candidate
Date ...........................
Place............ ..............
FOR OFFICE USE ONLY
Accepted / Rejected
............................
............................
Scrutinized by
Checked by
IMPORTANT INSTRUCTIONS TO BE FOLLOWED BY THE CANDIDATE
1. Please read carefully the instructions given in the application, as well as in the
prospectus and fee circular before filling the application.
2. IT IS COMPULSORY FOR THE CANDIDATE TO ENCLOSE ATTESTED
PHOTO COPIES OF THE PREVIOUS YEAR MARKS CARDS WITHOUT
FAIL.
3. The application along with the Examination (original) and Admission
(xerox copy) Fee paid challans should be submitted on or before the due date
(with or without penal fee as prescribed in the fee circular). Otherwise, the
application will be rejected.
4. Freshers, who have enrolled for I, II or III year B.A. course in the current
academic year should compulsorily pay the examination fee in full and must
appear for all the subjects/papers in their respective class.
5. Incomplete applications are liable to be rejected.
Karnataka State Open University, Mysore
Name of the Bank &
Place of Remittance..............................................
Name of the Course B.A : I / II / III
Roll No :
KSOU-500-EXAMINATION FUND
SBM : 54035420128 SBI : 31106997538
ORIGINAL
SBM, Mukthagangotri, Mysore - 06 Code -40166
SBI, New Sayyaji Rao Road, Mysore - 01 - Code-3130
Name and Address of the Student
KS
C
U
O
Y
P
O
Amount Rs.
6. The prescribed examination fee should be remitted in the bank through the
challan printed in the examination form.
501 : Examination Fee
Penal Fee
Change of Centre Fee
:
:
:
7. Examination Fees once paid will not be re-adjusted / refunded under any
circumstances.
Amount ( in words) Rupees ......................................
...................................................................................
Note : Fees once paid will not be Refunded.
8. Regarding the rates of Examination Fees, separate Circular is enclosed.
9. For all instructions pertaining to the examination Dates, Centres,
Assignments, Time Table, Announcement of Result, Convocation Dates etc.,
please see the KSOU Website:www.ksoumysore.edu.in.
10.The filled - in application should be submitted to the REGISTRAR
(EVALUATION), Karnataka State Open University, Mukthagangotri,
Mysore - 570 006.
11. MOBILE PHONES ARE STRICTLY PROHIBITED IN THE EXAMINATION HALL.
Date :
Signature of Remitter
____________________________________________
For the use of the Bank
The Amount of Rupees ( In words).............................
.....................................................................................
has been received /
Challan No.
Date &
Bank Seal
Signature of the Officer
receiving the money
UNIVERSITY COPY
Not to be separated from the Form
PY
Roll No :
S
/S
M
B
Y
has been received /
Challan No.
Date &
Bank Seal
receiving the money
has been received /
Challan No.
Date &
Bank Seal
receiving the money
The Amount of Rupees ( In words).....................
............................................................................
Date :
____________________________________________
Date :
____________________________________________
............................................................................
...................................................................................
...................................................................................
Amount Rs.
E
P
CO
:
Penal Fee
:
Change of Centre Fee :
M
BI
R
YS O
SBM, Mukthagangotri, Mysore - 06
SBI, New Sayyaji Rao Road, Mysore - 01
Code -40166
Code-3130
SBI : 31106997538
Triplicate
SBM : 54035420128
SBI : 31106997538
ST
Amount Rs.
Y
P
O
Code -40166
Code-3130
has been received /
Challan No.
Date &
Bank Seal
receiving the money
............................................................................
Date :
____________________________________________
...................................................................................
:
Penal Fee
:
E
D
U
C
T
N
Quadruplicate
SBM : 54035420128
Roll No :
Name of the Bank &
Name of the Bank &
Penal Fee
:
O
C
Amount Rs.
NK
A
B
:
Code -40166
Code-3130
SBI : 31106997538
Duplicate
SBM : 54035420128
Roll No :
Name of the Bank &

B.A. Exam application.cdr - Karnataka State Open University

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