KARNATAKA STATE ELIGIBILITY TEST (KSET) FOR LECTURESHIP
DECEMBER - 2018 Print copy of Application Form (ONE COPY TO BE SUBMITTED TO THE NODAL OFFICER OF THE TEST CENTER)
To be Filled by the Test Center Only
Roll No.: 14100011
Ref No.: 9958
Prof. J. K. Raju Nodal Officer, KSET Department of Business Administration, Tolahunase, Davanagere University, Shivagangothri, Davanagere - 577 002.
Subject Code: 10 Center Code: 14 Category: ST
Personal Information Affix recent
Passport size 1. Name : SMITHA K B Photograph signed by the candidate 2. Date of Birth : 19-Jul-1992 and duly attested 3. Age as on (31-07-2018) : 26 years, 0 month, 12 day by the Head of the 4. Sex : Female Dept./Institution or 5. Category : ST Class I Gezetted Officer. 6. Visually handicapped : NO (VH) (DO NOT STAPLE 7. Physically handicapped OR PIN) : NO (PH) 8. Father's Name : BASAVANNEPPA 9. Mother's Name : SHASHIKALA 10. Address for : #567/31,32, Saraswathi nagar 'B' Block,Behind Church, Nittuvalli, Communication Davanagere- 577004 : #567/31,32, Saraswathi nagar 'B' Block, Behind Church, Nittuvalli, 11. Permanent Address Davanagere- 577004 12. Post Graduation : Passed Examination 13. Subject of Post- : Management - Finance Graduation 14. Subject opted for KSET : Management 15. Center of Examination : Davanagere - Davanagere University, selected 16. Examination Appearing : Passed / Passed 17. Name of the University : Davanagere University 18. Year of Passing : 2016 19. Subject Offered : Management - Finance 20. Marks obtained : 6.15 21. Total Marks : 10 22. Aggregate % of marks : 61.5 obtained 23. Mobile No. : 9538525410 24. Email ID : smithakb.kb@gmail.com
http://kset.uni-mysore.ac.in/app/index.php/myprints/application_form 1/2 9/15/2018 Application Form
Details of Fee Paid
26. Payment Mode : SBDEBIT
27. Bank Reference No. : DU98999211 28. Deposit Date : 11-Sep-2018 29. Amount : Rs. 550
Declaration
i. I, SMITHA K B, applicant for KSET - 2018, hereby declare that all statement made in this application are true, complete and correct to the best of my knowledge and belief and in the event of any information being found false or incorrect or any ineligibility being detected before or after the test, my candidature is liable to be cancelled and legal action may be initiated against me. ii. I fullfill all the conditions of eligibility regarding age limit, educational qualification etc. prescribed for the test. iii. I have gone through the Notification of KSET - 2018 and shall abide by the same. iv. I have deposited the required fee. v. I have noted that if my application is found incomplete / defective, the same is liable to be rejected summarily and no correspondence will be entertained in this regard. vi. I have read and agree with the Notification for the KSET - 2018, including instructions, enclosures, check list and other relevant information.
Place: Davanagere Date: 11-Sep-2018 Signature of Candidate _______________________
