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    Application Form - Distance

    Uploaded by

    Vijay Xavier
    This document is an application form for examinations from Alagappa University's Distance Education program. It requests information from the applicant such as name, address, enrollment number, exam center, subjects appearing for, and exam fees payment details. The form also verifies that the applicant has paid course fees due to the university and lists the subjects the applicant will be appearing for in the exams.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    Application Form - Distance

    Uploaded by

    Vijay Xavier
    79 views2 pages
    This document is an application form for examinations from Alagappa University's Distance Education program. It requests information from the applicant such as name, address, enrollment number, exam center, subjects appearing for, and exam fees payment details. The form also verifies that the applicant has paid course fees due to the university and lists the subjects the applicant will be appearing for in the exams.

    Original Title

    APPLICATION FORM- DISTANCE

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    © Attribution Non-Commercial (BY-NC)

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    This document is an application form for examinations from Alagappa University's Distance Education program. It requests information from the applicant such as name, address, enrollment number, exam center, subjects appearing for, and exam fees payment details. The form also verifies that the applicant has paid course fees due to the university and lists the subjects the applicant will be appearing for in the exams.

    Copyright:

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

    Application Form - Distance

    Uploaded by

    Vijay Xavier
    This document is an application form for examinations from Alagappa University's Distance Education program. It requests information from the applicant such as name, address, enrollment number, exam center, subjects appearing for, and exam fees payment details. The form also verifies that the applicant has paid course fees due to the university and lists the subjects the applicant will be appearing for in the exams.

    Copyright:

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

    (Accredited with ‘A’ Grade by NAAC)


    KARAIKUDI – 630 003.TAMILNADU
    DISTANCE EDUCATION
    APPLICATION FOR EXAMINATIONS

    1. Course : 2. Exam Centre with


    Centre Code :
    3. Name of the Study Centre : 4. Month & year of Exam :

    1. Name of the applicant(in Block letters) :

    2. Father’s Name :

    3. Sex : M F

    4. Enrolment No. :

    5. Permanent Address with Pincode :

    6. Year/Semester for which you are appearing


    (Both Regular and Arrears) :

    7. EXAMINATION FEES PAYMENT DETAILS Total


    Details Nos Amount
    Rs.
    a) Amount paid : Rs. 1. Subject(s) fee

    2. Practical(s) /
    b) D.D. Number : Dissertation fee

    c) Date of payment : 3. Certificate fee


    (including Exam
    d) Name and place of : Application fee,
    issuing Bank Mark Statement fee,
    Provisional
    Certificate fee,
    8. *Have your paid the course : Yes/No Degree Certificate
    fees due to the University fee) to be paid only
    during first
    Station: appearance.
    4. Late fee

    Date: Total Rs.


    Signature of the Candidate

    Verified by:

    CONTROLLER OF EXAMINATIONS
    * Those who have not remitted Second / Third year Course fees will not be permitted to
    appear for the examination
    9. Subjects in which you are appearing

    Title of the Paper


    Subject FIRST YEAR / FIRST SEMESTER Subject FIRST YEAR / SECOND SEMESTER
    Code Code

    SECOND YEAR / THIRD SEMESTER SECOND YEAR / FOURTH SEMESTER

    THIRD YEAR / FIFTH SEMESTER THIRD YEAR / SIXTH SEMESTER

    Score out the letters and numerals which are not applicable to you

    ---------------------------------------------------------------------------------------------------------------------
    ALAGAPPA UNIVERSITY
    (Accredited with ‘A’ Grade by NAAC)
    KARAIKUDI – 630 003
    DISTANCE EDUCATION EXAMINATIONS, 200
    HALL TICKET
    (To be filled in by the candidate)
    Name of the Candidate :
    Photo to be
    Course : affixed
    Enrolment Number : here
    Examination Centre :
    SUBJECTS APPEARING (Write the subject code only)

    Signature of the Candidate Controller of Examinations

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