APPLICATION FORM (PG PROGRAMS)
SESSION
MEWAR UNIVERSIT Y
2 0 1 5 - 1 6
(A university u/s 2(f) of the UGC Act 1956 with the right to confer degrees
u/s 22(1) of the UGC Act; set up by Rajasthan Govt. Act 4 of 2009)
INSTRUCTIONS :
(Member, Association of Indian Universities)
1.
2.
3.
4.
5.
6.
Gangrar, Chittorgarh, (Rajasthan)-312 901
Ph. 01471-220881/2/3/4, Fax: 01471-220886
Website: [Link]
Incomplete Application Form will not be considered
Read Prospectus carefully before filling the Application Form
Use Black / Blue Ball Pen only to fill the Application Form
Write the details in BLOCK LETTERS only
Demand Draft should be in favour of Mewar University payable at Chittorgarh/Ghaziabad
Tick Mark ( ) the appropriate box only
FOR OFFICE USE ONLY
Course Applying for
[Link]
[Link]
[Link]
M.A.
MBA
Executive MBA
Affix your
latest passport
size colour
photograph
within the box
Specialization/Branch
Are you GATE Qualified?
No If yes, valid GATE percentile
Yes
Year
D
PERSONAL INFORMATION (Exactly as appears in the certificate of qualifying examination)
Date of Birth
Student's Name
Male
Father's Name
Gender
Mother's Name
Nationality Indian
Category
SC
ST
OBC
Minority
General
Address for Correspondence
Permanent Address
Name
Name
Address :
PH
Female
Other
Internal
Address :
.
City :
District :
State
Pin Code :
City :
District :
State :
Pin Code :
Mobile Number (Self)
Telephone Nos. with STD code
Mobile Number (Second)
E-mail
Payment Details
Demand Draft / Payorder No. / Cash Receipt No. ............................................................... Dated ............................ Drawn on ..................................................
Branch .............................................................. for Rs. 1000 (rupees one thousand only) (The Demad Draft/pay order of Rs. 1000 (rupees one thousand only)
is to be drawn in pavour of MEWAR UNIVERSITY payable at Chittorgarh/Ghaziabad as Registration Fees.)
QUALIFYING EXAMINATION PARTICULARS
Name of Qualifying Exam
Discipline (Applicable)
Duration & Year of Passing
Name of College/ Institute
Basis of Admission
Entrance Exam
Left Hand Thumb Impression of the Candidate
Interview
Merit
Signature of the Candidate
ACADEMIC QUALIFICATIONS
Exam/Degree
Name of Institute,
Board/University
Year of
Passing
Medium of
Instruction
% of Marks/CGPA/
Overall Grade
Subjects
10th (Matriculation) or
its Equivalent
12th (Intermediate) or
its Equivalent
Graduation or its
Equivalent
Post Graduation or its
Equivalent
Other (if any)
EXTRA CURRICULAR ACTIVITIES
(Furnish in brief the particulars of achievements in sports/cultural/and other co-curricular activities)
Particulars of Activity
Year
Level (College/
State/National)
Achievement with remarks (if any)
DETAILS OF DISCIPLINARY ACTION (If any)
Has any disciplinary action been taken against you :
(If yes, please furnish the following details)
No
Yes
Particulars of Disciplinary Action
Year
Name of the Institution
LIST OF ENCLOSURES
Sr.
No.
Particulars
1.
Attested copy of matriculation or its
equivalent certificate for DOB testimony
2.
Attested copy of marksheet of
qualifying examination
3.
One recent passport size coloured
photograph
4.
Proof of payment (Demand Draft/Receipt
of cash deposited)
5.
Migration/Transfer Certificate
6.
Caste/Category Certificate (if applicable)
Mark 'NA'
if not
applicable
Marks 'O' if
submitted in
original and 'X' if
Xerox is Submitted
If pending for
submission
(Specify date of
submission)
Office remarks
Declaration & Certification
I, the undersigned, hereby declare and certify that:
(i)
All information hereby submitted and stated by me during the course of admission and related thereto, to the best of my knowledge and belief is complete, true and
factually correct and all the supporting to this form submitted to Mewar University are authentic. I undertake that I would be subject to all sorts of disciplinary action that
University may deemed fit to take against me including but not restricted to cancellation of my admission or expulsion or rustication and other actions as per applicable
laws, in case the documents and information submitted and stated herewith found false, incorrect or misrepresented by me.
(ii)
The University has all the rights to accept my admission or reject the same; mere submission of form along with fee does not mean that admission has been confirmed. The
admission would be understood as confirmed when the University will issue the admit card or do such act that pertains to confirmation of admission.
(iii)
In case of my withdrawal from the programme for any personal reason or due to expulsion or rustication from the University on disciplinary actions, I would not be entitled
for any refund of fees or other amount paid.
Name in BLOCK LETTERS
Date
Signature of Candidate
NOTE : PHOTOCOPY OF THE FILLED APPLICATION FORM MUST BE RETAINED BY THE CANDIDATE FOR FURTHER USE.
