APPLICATION FORM TO APPEAR FOR THE UG/PG/MBA/MCA DEGREE/ALL DIPLOMA
ARREAR EXAMINATION [FOR THE STUDENTS OF DISTANCE EDUCATION]
DECEMBER 2016
1. Month & year of Examination
DECEMBER 2016
2. a) Examination Centre Code :
3. Name of the Candidate [In capital letters) :
4. Date of Birth :
5. Enrolment Number :
6. Examination Register No. (Allotted in the previous appearance):
7. Month and year of last examination appeared:
8. Address for communication with Cell No.:
9. Degree & Branch :
10. Subjects to which the candidate takes up the examination appearing in this appearance: Title of subjects (Theory and / or Practical]
Subject code
[PTO]
.. 2 ..
Details of Payment & Fee:
1. D.D. No._______________________________ 2. Date __________________________________ 3. Bank __________________________________ 4. Rs._____________________________________ DECLARATION It is, hereby, declared that the particulars furnished above are true to the best of my knowledge. I have read the instructions and understood that my candidature will be cancelled if any of the information furnished is found false.