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    OPENMAT Entrance Form

    Uploaded by

    Kanimozhi Ponnuchamy
    This document is an application form for the IGNOU OpenMat entrance exam. It requests information such as personal details, education history, contact information, employment, and a declaration of truthfulness from the applicant. The form instructs applicants to submit it by registered post to the IGNOU Student Evaluation Division office in New Delhi by August 8th, 2013 for OpenMat XXXIV and December 15th, 2013 for OpenMat XXXV. Applicants are also told not to attach any documents to the form.

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    Download as PDF, TXT or read online from Scribd

    OPENMAT Entrance Form

    Uploaded by

    Kanimozhi Ponnuchamy
    45 views2 pages
    This document is an application form for the IGNOU OpenMat entrance exam. It requests information such as personal details, education history, contact information, employment, and a declaration of truthfulness from the applicant. The form instructs applicants to submit it by registered post to the IGNOU Student Evaluation Division office in New Delhi by August 8th, 2013 for OpenMat XXXIV and December 15th, 2013 for OpenMat XXXV. Applicants are also told not to attach any documents to the form.

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    Original Title

    OPENMAT Entrance Form(2)

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    This document is an application form for the IGNOU OpenMat entrance exam. It requests information such as personal details, education history, contact information, employment, and a declaration of truthfulness from the applicant. The form instructs applicants to submit it by registered post to the IGNOU Student Evaluation Division office in New Delhi by August 8th, 2013 for OpenMat XXXIV and December 15th, 2013 for OpenMat XXXV. Applicants are also told not to attach any documents to the form.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    45 views2 pages

    OPENMAT Entrance Form

    Uploaded by

    Kanimozhi Ponnuchamy
    This document is an application form for the IGNOU OpenMat entrance exam. It requests information such as personal details, education history, contact information, employment, and a declaration of truthfulness from the applicant. The form instructs applicants to submit it by registered post to the IGNOU Student Evaluation Division office in New Delhi by August 8th, 2013 for OpenMat XXXIV and December 15th, 2013 for OpenMat XXXV. Applicants are also told not to attach any documents to the form.

    Copyright:

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    You are on page 1of 2

    INDIRA GANDHI NATIONAL OPEN UNIVERSITY

    MAIDAN GARHI, NEW DELHI-110 068


    APPLICATION FORM FOR OPENMAT - XXXIV & XXXV ENTRANCE TEST

    FORM NO. 1 FORM NO.:

    INSTRUCTIONS
    1. 2. 3. 4. 5. Please read the instructions in the information brochure before filling up this form. Use BLACK BALL POINT PEN in boxes using English capital letters or English numerals. Do not make any stray marks on this sheet. Do not staple, pin, wrinkle scribble, tear or wet this sheet. Write in CAPITAL LETTERS only within the box without touching the lines as shown in the Sample below.

    CONTROL NUMBER:

    0 1 2

    5 6

    7 8 9 A B C D E F G H

    L M N O P Q R S

    T U V W X Y Z

    1. Regional Centre Code 5. Nationality


    (Write the relevant code in the box) A1 - Indian B2 - Others

    2. Exam Centre Code 6. Sex


    (Write the relevant code in the box) A1 - Male B2 - Female

    3. State Code

    4. Category

    A1 - GEN C3 - ST B2 - SC D4 - OBC (Write the relevant D4A - Creamy Layer code in the box) D4B - NonCreamy Layer

    7. Marital Status
    (Write the relevant code in the box) A1 - Married B2 - Unmarried

    8. Whether Minority:
    (Write the relevant code in the box) A1 Yes B2 No (Write the relevant code in the box)

    9. Religion

    (Write the relevant code in the box)

    A1 Hindu D4 Sikh B2 Muslim E5 Jain C3 Christian F6 Buddhist

    G7 Parsi H8 Jews I 9 Others

    10. Date of Birth Month Date

    11. Social Status

    12. Whether Kashmiri Migrant


    (Write the relevant code in the box) A1 Yes B2 No

    Year
    A1 Ex-service man B2 War widow C3 Not applicable

    13. Territory
    A1 - URBAN B2 - RURAL C3 - TRIBAL

    14. Employment Status


    A1 - Employed B2 - Unemployed C3 - IGNOU Regular Employee D4 - KVS Employee

    15.a. Whether Physically Handicapped:


    A1 - Yes B2 - No

    15.b. If physically handicapped (nature of disability)


    A1 Hearing Impairment B2 Locomotor Impairment C3 Visual Impairment D4 Reading Disability E5 Any other, Please specify

    16.a. Are you registered with IGNOU


    (Write the relevant code in the box) A1 Yes B2 No

    16.b. If yes, write the Enrol. No. & Programme Code in the boxes below :
    Enrolment No. Programme Code

    17. Details of Scholarship being received if any


    (a) Annual Scholarship Amount

    (b) Dept. Offering (Write the relevant code in the box) Scholarship
    A1 Govt. Deptt. B2 Other

    (c) Family income (yearly)

    Fold from here

    18. Name of the Candidate

    19. Name of Father/Mother/Husband (strike out whichever hot applicable)

    20. (a) Educational Qualifications (Which makes you eligible for the programme)

    Qualification Code

    Year of Passing

    Percentage of marks

    20. (b) Stream: (Cross (X) any one of the Appropriate Box only) NON-GRADUATE (10+2 or its equivalent) Arts Commerce Science

    Engineering

    Others

    GRADUATE POST GRADUATE


    21. Write Name & Complete Mailing Address (In BLACK BALL Point Pen only) 22. For Office Use
    Enrollment No.:

    24. Photograph

    Name : Address:
    23. Candidate's Signature
    Affix your latest passport size photograph (4 cm x 5 cm) duly attested by Gazetted Officer

    PIN CODE :

    25. Working Experience

    Duration

    Years

    Months.

    Employed in (Cross (X) any one of the Appropriate Box only)

    Govt./Public Sector

    Semi Govt.

    Pvt. Sector

    Self Employed

    Annual Income (Cross (X) any one of the Appropriate Box only)

    Upto

    50,000/-

    50,000 to 1 lac Above 2 lacs

    1 lac to 1.5 lac

    1.5 lac to 2 lac

    26. Address for Correspondence (Do not give Post Box No. address. Leave a blank box between each unit of address like House No., Street Name, P.O., etc.)

    City

    District

    State

    Pin Code

    27. Telephone Number(If any) with STD Code/Mobile No.


    STD Code Telephone No.

    28. Fax No. (If any) with STD Code


    STD Code Telephone No.

    29. E-mail address/ID (If any)

    DECLARATION BY APPLICANT
    I hereby declare that I have read and understood the conditions of eligibility for the programme for which I seek admission. I fulfil the minimum eligibility criteria and have provided necessary information in this regard. In the event of any information being found incorrect or misleading, my candidature shall be liable to cancellation by the University at any time and I shall not be entitled to refund of any fee paid by me to the University I have carefully studied the rules of the University as printed in the Prospectus and I accept them and shall not raise any dispute in future over the same rules.

    Date:

    (Signature of the Applicant)

    INSTRUCTIONS FOR CANDIDATES


    1. Please send your Application form by Registered/Speed Post to the following Address : Registrar Student Evaluation Division IGNOU, MAIDAN GARHI, NEW DELHI - 110068 2. Last date for receipt of filled in application form for XXXIV OPENMAT is 8th August, 2013 and for OPENMAT - XXXV is 15th December, 2013. 3. Application form received after the due date will not be accepted. 4. Please retain photo copy of the filled application form for future reference. 5. For Detailed instructions please refer Students Handbook & Prospectus. 6. No documents are to be attached with this application form.

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