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For Office Use only

Examination Roll No…………………….

ALIGARH

MUSLIM

UNIVERSITY,

ALIGARH

RX

Course of Study

Branch/Main Subject/Specialization (if any):

Y ear/Part/Semester/Term/Prof For Graduation -Subsidiary (1) (If applicable) Comp. (1) (2) Regular
Y ear/Part/Semester/Term/Prof
For Graduation -Subsidiary
(1)
(If applicable)
Comp. (1)
(2)
Regular

Session

(2)

(3)

Ex-Student

For Graduation -Subsidiary (1) (If applicable) Comp. (1) (2) Regular Session (2) (3) Ex-Student

PASTE (do not staple) recent PHOTOGRAPH 2.5 x 3 cms. duly attested by the Certifying Authority

Cash Receipt No.

Dated

Rs.

Enrolment No.

Enrolment No. ----------------------------

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Faculty No.

Faculty No. ----------------------------

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1. Name (in block letters) Mr. / Ms.

 

:

(As per HS/SSC or equivalent examination)

 

2. Date of Birth in Christian Era

 

:

(In figures)

 

:

(In Words)

3. Sex

:

4. Father's Name

:

5. Mother's Name

:

6. Religion (In case of Muslims, state

 

:

Sunni or Shia)/Caste for Non-Muslims

 

Religion

(Sunni or Shia) /(SC / ST / BC)

7. Permanent Address

(in full)

:

 

:

:

8. Was the candidate ever debarred, disqualified,

 

:

Examination

Year

detained, suspended, rusticated ? If so, give (attach photocopies of the Office orders)

details

Roll No Punishment awarded

Period

9. Is the candidate appearing in Improvement Examination (Yes / No)

 

:

10. Is the candidate appearing or has appeared at:

 

Year

Roll

any other examination of this University or any other examining body this year ? If so, give details.

:

Examining Body

11. Details of Examination at which the candidate last appeared as Regular/Ex-Student but failed

:

:

Regular / Ex-Student Exam. Roll No

Result

*12. Details of Last Examination Passed :

Name of the Examination

Y ear of Passing

     

% of

 

Roll No.

Name of University/Board

Result

Marks

Subjects Offered

* Candidate is required to enclose self attested photocopy of marksheet.

NOTE:

1.

This Examination Form is applicable for Regular / Ex-Student, desiring to appear in the examination of the courses, mentioned on the back page of the Hall-Ticket.

2.

The students must tick the column of Regular /Ex-Students, whichever is applicable as per Ordinances (Academic).

3.

Please see the back page of the Hall-Ticket for details of Examination Fee payable.

[2]

13. Specify the

Papers and their Codes (including Practicals/Seminar/Viva-V oce, etc.). in which the candidate intends to appear in

the Examination.

CODE NO.

TITLE OF PAPERS

 

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Backlog Papers (if any)

……………………………………………………………………………………………………………………………………………………………………………

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NOTE:

Candidates with Madarsa background studying in M.A. (Arabic/Islamic Studies/ M.Th.) Should also clear English Paper of SSSC level for award of Degree.

DECLARATION

I hereby solemnly affirm that I have filled this Examination Form myself. If it is discovered at any stage that I have made a false or incorrect

statement or concealed the facts or fraudulent means have been used by me for appearing at the examination, I shall be liable to disciplinary action and my examination result may be cancelled. I further affirm that I have not taken Migration Certificate from this University/submitted the Migration Certificate.

I shall abide by all the rules and regulations of the University as amended and enforced from time to time.

Hall

Hostel

Room

Left (Male)

Right (Female)

Thumb

Impression

Address for Correspondence (in Block Letters)

………………………………………… (Signature of the candidate in full) } Dated:

Pin :

Contact No.

of the candidate in full) } Dated: Pin : Contact No. … … … … …

FOR OFFICE USE ONLY

Certificate to be signed by the Provost

This is to certify that:

(a) the candidate is/was a regular member of this Hall during the current session/during the

session

Signature (with Seal)

Dated:

and his/her Hall dues are clear as on date.

(Provost)

Certificate to be signed by the Dean/Principal/Coordinator/Director concerned:This is to certify that the student :

(a)

is a regular/ex-student of the course of study as detailed in

this Examination Form.

(b)

(c)

(d)

fulfils the conditions as laid down in the Ordinances (Academic)/Regulations relating to the course.

has chosen the Title of papers and their Codes correctly.

has submitted the original marksheet in this office (in case of appearing for Improvement)

Signature (with Seal) Dated:

(Dean/Principal/C -coordinator/Director

This Page not to be filled in by B.Tech./M. Tech. students of F/o Engg. & Technology

[3]

For Office Use only Examination Roll No………………….……

For Office Use only

Examination Roll No………………….……

Examination Roll No………………….……

ALIGARH

MUSLIM

Regular / Ex

UNIVERSITY ,

HALL TICKET

Note: Mention the Code & T itle of Papers/Practicals/Seminar, etc. carefully . No Corrections / overwriting shall be accepted unless verified by the University authority.

Course of Study

Branch/Main Subject/Specialization (if any):

Y ear/Part/Semester/Term/Prof

S. ession

ALIGARH

PASTE (do not staple) recent PHOTOGRAPH 2.5 x 3 cms. duly attested by the Certifying Authority

Regular Name of the Candidate
Regular
Name of
the Candidate

(in Block Letters)

Ex-Student

Hall

Name of the Candidate (in Block Letters) Ex-Student Hall Faculty Enrolment (Papers and their Codes (including

Faculty

Enrolment

(Papers and their Codes (including Practicals/Seminar/Viva-Voce, etc.).

CODE NO.

TITLE OF PAPERS

…………………………

……………………………………………………………………………………………………………………………….

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Backlog Papers (if any)

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Permitted to appear in (

Dealing Assistant (Examination) Dated ………………

) Papers.

Left (Male)

Right (Female)

Thumb

Impression

(Signature of the Candidate)

Dated

S.O. /Assistant Controller (Examinations) Dated …………………

[4]

DETAILS OF EXAMINATION FEE

 

C ou r se

Examination Fee

Fee per

 

Regular

Ex-Student

Backlog Paper

M.A./M.Sc./M.Com./M.P .E./M.F.A./M.S.W./M.A.E.B.M./M.Tec (Ag.)/M.B.A./M.B.A.(I.B.) M.F.C./M.T.A./M.Th./M.Ed.

Rs. 60/-

Rs. 70/-

Rs. 50/-

M.C.A./LL.M

Rs. 100/-

Rs. 110/-

Rs. 50/-

 

M.L.I.Sc.

Rs. 50/-

Rs. 60/-

--------

M.D. (Unani)/M.S.(Jarahat)

Rs. 100/-

--------

--------

M.D./M.S.(F/o Medicine)

Rs. 400/-

Rs. 410/-

--------

B.A./B.Sc./B.Com.(Hons.)/B.C.A./BC.M./B.I.T./B.F.A./B.T ./B.Ed.

Rs. 60/-

Rs. 70/-

Rs. 25/-

B.P .Ed./BRTT I Yea

Rs. 200/-

Rs. 210/-

--------

 

B.L.I.Sc.

Rs. 50/-

Rs. 60/-

--------

B.A.LLB./B.E. III/IV Yea

Rs. 100/-

Rs. 110/-

Rs. 25/-

B.U.M.S. Pre-Tib.

Rs. 25/-

Rs. 35/-

--------

B.U.M.S. First Professional

Rs. 35/-

Rs. 45/-

--------

B.U.M.S. Second/Third Professiona

Rs. 50/-

Rs. 60/-

--------

M.B.B.S./B.D.S. First Professiona

Rs. 100/-

 

--------

M.B.B.S./B.D.S. Second to Final Professiona

Rs. 150/-

Rs. 160/-

--------

B.

Tech./B.Arch. I, II, III & IV Semeste

Rs. 50/-

--------

--------

B.

Tech./B.Arch. V , VI, VII, VIII, IX, X Semest

Rs. 100/-

--------

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Diploma in Engg. I Y ea

Rs. 30/-

Rs. 40/-

Rs. 25/-

Diploma in Engg. II Yea

Rs. 40/-

Rs. 50/-

Rs. 25/-

B.E. I/II year/Diploma in Engg. III Y ea

Rs. 50/-

Rs. 60/-

Rs. 25/-

 

M. Tech

Rs. 150/-

 

Rs. 25/-

C ou r se

Exa m ination Fee

Regular

Ex-Student

Cert. / Dip. in Qira’at, Shia Theology

Rs. 15/-

Rs. 25/-

Cert./Dip. of Proficiency in Languages/Certificate in Professional kills Regular/ Short Term.

Rs. 20/-

Rs. 30/-

Cert. / Dip. in Linguistics

Rs. 30/-

Rs. 40/-

Dip. in Teaching/ W est Asian Studies/ Crt. in. RS & GIS application in environment studies/Wild Life Ecology Management/ Dip. /P .G. Dip. in Rs. 50/- Professional Courses (1 year)/Dip./Cert. in Professional Courses (2/3 years)

 

Rs. 60/-

P .G. Dip. in Banking Risk & Insurance Management (BRIM)/P .G. Dip. in Islami Banking and Finance.

Rs. 60/-

Rs. 70/-

P .G. Dip. Translation (Hindi)/ Post M.A. / M.Sc. Dip. /Dip. in Tanslation (Urdu)/P .G. Dip. in Personnel Management/ Marketing Management/ Business Finance/P .G. Dip. in conflict resolution and Peace Studies / P .G. Dip. in Hydrology/ Cert./Dip. Course in Urdu Electronic Media.

Rs. 100/-

Rs. 110/-

P .G. Dip. in Languagesof Advertising Media & market/ Biodiversity Managemen

   

Conservation/P .G. Dip. in Women’s Studies & Mass Communication (Urdu)/ Rs. 200/- Advance Dip. in French/ Dip. in Surgical Endoscopic Techniques/Physiotherapy &

Rs. 210/-

Rehabilitation.

P .G. Diploma Courses (F/o Medicine)

Rs. 400/-

Rs. 410/-

Note:

necessary documents is to be submitted in the office of the Dean / Principal / Coordinator / Director concerned for onward transmission to Assistant Controller, Examination Division, Controller’s Office on or before the notified

last date.

The Examination Form along

with the Cash Receipt (in original) of prescribed examination fee and