MADURAI KAMARAJ UNIVERSITY
[Link]., / [Link]. (NON –SEMESTER) DEGREE EXAMINATION APPLICATION
APRIL/NOVEMBER-2015
SPACE FOR
PHOTOGRAPH
Year of Admission :
Duly attested by
Name of the College : The Principal
Examination Centre Code :
Examination Register Number :
In English (in Block Letters)
1. NAME
In Tamil
SEX Date of Name of Father
Birth
2.
Name of Mother
OC BC MBC DNC SC ST
3. Community
[Link]-I
Paper-II
Paper-III
ELECTIVE 1)
2)
5. SUBJECT CODES FOR WHICH APPEARING NOW INCLUDING PRACTICALS
THEORY
Total Number of Subjects
6. Fee Paid Particulars:
Name of Bank :
Place of Bank :
Amount :
SBI Reference No :
Date :
7. Whether the candidate has committed any
Malpractice in the previous Examination and if so
Mention the details
The month and year of passing the qualifying Degree
8. Examination of this University and the Register Number
(i.e. U.G/P.G/[Link].,)
If the student is from other University. State the name
of the University and qualifying Examination passed (i.e.
9.
U.G/P.G/[Link].)
Whether the Candidate has remitted the eligibility (for
10.
Other State students) and recognition fees and if so.
Give the details, In case of Other State students attach
the Xerox copy of Provisional Eligibility Certificate
obtained from the University.
I declare that the particulars furnished above are true to the best of my knowledge and
belief.
I do hereby further agree and abide that any dispute arising between the University and
myself relating to the Examinations to be held. Shall be re solved/decided by the court
/forum/Tribunal situated within the territorial jurisdiction wherein the University is situated and
no other the court/ forum/Tribunal will have any jurisdiction to resolve/decide the dispute
between the University and myself irrespective of the fact that the course of action arises within
other court jurisdiction.
Station:
Date : Signature of the Candidate
Certified that the particulars furnished above by the candidate is correct.
Signature of the Principal
Residential Address :
……………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………...
(To be enclosed with the application)
MADURAI KAMARAI UNIVERSITY
IDENTIFICATION CETIFICATE
[Link].
Centre Code No.
[Link].,(Non-Semester)Examination April/November 2015 SPACE FOR
PHOTOGRAPH
This is to certify that
Thiru/Selvi/Tmty. Duly attested
by The
Principal
S/o D/o W/o
Appearing for the Degree (Non-Semester) Examination, April/November 2015 is
Well known to me and his/her signature, given below is attested by me. This is certified that the photo
copy of the above candidate is attested by me.
Specimens Signature of the Candidate
Signature of the Identifying officer
SPECIAL INSTRUCTION WITH REGARD TO PHOTOGRAPH
[Link] copy of the photograph should be pasted in the space provided in the application form and the other should
be pasted in the space provided in the identification certificate attached with this application .These two copies
should be identical.
[Link] Candidate should sigh his /her full signature along the top margin of the photo copy. The signature on the
photo copies should confirm in every detail to the signature in the application.
[Link] photo should be attested only by the Principal of the college where the student last studied.
The officer who has signed the photograph should also certify in the space provided for this purpose in the
application form, to his personal knowledge of the candidates.
EXAMINATION FEE PARTICULARS:
Special fees = 7000
[Link] Theory Papers 250x5=1250.00
(for each paper Rs.250/-)
[Link] of applications = 50.00
[Link] Statement of Marks = 100.00
The Last date for receipt of filled in application form
without penalty : 08.05.2015
The Last date for receipt of filled in application form
with the penalty of Rs.200/-:15.05.2015
N.B.: Examination applications received without the attested Xerox copy of the UG/PG and [Link].,
degree Marks Statement and Provisional Certificate will summarily be rejected.
* (Mode of payment ONLY THROUGH SBI “ONLINE PAYMENT”)