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YEAR OF ADMISSION

ROLL / ID CARD NO

KARNATAKA STATE

OPEN UNIVERSITY

MANASAGANGOTRI, MYSORE-570 006 Bharath Postgraduate College (Academic Collaborative Institution) APPLICATION FORM FOR EXAMINATION
Mobile No:. Landline No: Email ID: . Note: i) Please read carefully the instructions given overleaf before filling up the application, as well as instructions in the fee circular. ii) Strike off whichever is not applicable EXAMINATION CENTRE NAME OF THE EXAM CODE NO. CENTRE Study Centre Code Study Centre Name 1. Name of the candidates (in block letters): (as in qualifying examination records)

Affix Stamp Size Photo here

2. Name of the Father / Husband 3. ADDRESS IN FULL (in block letter) 4.Programme with Discipline / Specialization): 5.Course Code and Course Title in which candidate is appearing: S. N Sem/Year Course Code O 1 2 3 4 5 6 7 8 9 10

Course Title

6. Sex: Male / Female 7. Bank Draft Number with Details Bank Name

7. Medium : English

Amount in Rs

DD Number

DD date

I declare that the information furnished above by me is correct to the best of my knowledge. Date:.. Place:. .................... Signature of the Candidate

Certified that the Roll Number, Name, Examination Particulars have been verified and found correct as per the record Signature & Seal of the Centre Head of the Study Centre:

Accepted / Rejected
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FOR OFFICE USE ONLY ..

Scrutinized by

Checked by

IMIMIM IMPORTANT INSTRUCTIONS TO BE FOLLOWED BY THE CANDIDATES


01. The filled in application should be submitted to The Examination Incharge. Bharath Postgraduate College (A Partner of KSOU), 8,Karpagambal Nagar, Mylapore,Chennai-4,044-23451820 02. Candidates are requested to submit the Examination Fee through Challan 03. The application along with the DD should be submitted on or before the due date (without or with penal fee as prescribed in the fee circular). Otherwise, the application will NOT be registered for examination. 04. Incomplete applications are liable to be rejected. 05. Examination fees once paid will NOT be readjusted / refunded under any circumstances. 06. NO ADDITIONAL SHEET WILL BE ISSUED TO THE STUDENTS SINCE WE HAVE PROVIDED A BOOKLET CONTAINING 30 PAGES. STUDENTS SHOULD PLAN THEIR ANSWERS AND UTILISE ONLY THOSE PAGES EFFECTIVELY. 07. STUDENTS ARE PROHIBITED TO BRING MOBILE PHONES TO THE EXAMINATION HALL. 08. Exam fee in the Name of Bharath Postgraduate college payable at Chennai.