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    PLD B1 SKE 2018 - I - 16 Jan 24 - E0bAUFp

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    pookkom
    APPLICATION FOR RE-REGISTRATION (UG PROGRAMMES-2014 REGULATION)

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    PLD B1 SKE 2018 - I - 16 Jan 24 - E0bAUFp

    Uploaded by

    pookkom
    15 views4 pages
    APPLICATION FOR RE-REGISTRATION (UG PROGRAMMES-2014 REGULATION)

    Original Title

    PlD-B1-SKE-2018_I_16-Jan-24_E0bAUFp

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    © © All Rights Reserved

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    APPLICATION FOR RE-REGISTRATION (UG PROGRAMMES-2014 REGULATION)

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    15 views4 pages

    PLD B1 SKE 2018 - I - 16 Jan 24 - E0bAUFp

    Uploaded by

    pookkom
    APPLICATION FOR RE-REGISTRATION (UG PROGRAMMES-2014 REGULATION)

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 4

    KANNUR UNIVERSITY

    APPLICATION FORM FOR Mrs. SUDHA KRISHNAN ENDOWMENT - 2023

    Name of College &


    Govt. Aided
    Place
    Date of
    Admission Number
    admission
    Semester
    Academic year Programme

    1.Full Name (in Block letters)

    2. Date of Birth
    (as shown in S.S.L.C Book)

    3. Sex (Male /Female/Transgender)

    4. Nationality & Religion

    5. Community

    6. Details of Plus two/ CBSE/ICSE/


    Metric/ Other State Board
    a) Register Number with month and
    year of passing
    b) Percentage of marks
    7. Details of Present Programme of
    Study

    a) Name of the Programme.


    b) Duration (Number of Years)

    C) Period of study (Month & Year )


    ------------------------ to ----------------------

    8. Student’s Bank Account


    Number
    9. a) Name of the parent

    b) Occupation of the parent


    10. a) Guardian’s Name
    (If father & mother are not alive)

    b) Occupation of the Guardian

    11. a) Present Postal Address with


    Phone number

    b) Permanent Address

    12. Family Annual income: Rs.

    13. Family Ration Card No./ Aadhaar


    number of Parent

    It is declared that the above information is true and correct. If it is proved to be false, we will
    be held responsible and action can be initiated against us.

    Signature of the Parent/Guardian Signature of the Candidate

    (To be filled by the Educational institution)

    The contents of the application have been verified with the original documents submitted by
    the candidate to the College and the Photocopies of the same are enclosed herewith.
    Encl:
    1.Copy of the income Certificate
    2.Copy of the S.S.L.C book
    3.Copy of the Certificate/Marks memo of PLUS TWO
    4.Copy of the Ration Card or Aadhaar No.of the parent.
    5.Copy of the Occupation Certificate of the Parent.
    6.Bonafide Certificate issued by the Principal.

    Signature & Name of the Principal

    Place :

    Date: Seal:

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