VARDHAMAN MAHAVEER OPEN UNIVERSITY, KOTA
(Formerly – Kota Open University, Kota)
RAWATBHATA ROAD, KOTA (RAJ.) – 324021
APPLICATION FORM FOR ADMISSION
SESSION JANUARY / JULY 20___
(Please fill according to Guidelines attached)
ADMISSION FORM
Serial No.
Application No.
2. Programme Code
3. Regional Centre 4.Study Centre Code
PHOTOGRAPH
Affix your latest passport size
photograph
SIGNATURE
Put your Signature within the
box given below
5. Date of Birth (DD/MM/YYYY)
(Attach Certificate) / /
/ /
6. FEE DETAILS
Bank TR/JR No.
TR/JR No.Date Amount ₨
(Including Late Fee)
Issuing Bank
Rs. 100/- Extra (Admission form charges) for downloaded/Emailed form
1 - English
2 - Hindi
1. Scholar No. (For office use only)
(Leave Blank)
7. Name of Applicant (Leave one empty box between First Name, Middle Name and Surname)
8. Father’s Name of Applicant
9. Mother’s Name of Applicant
10. Address for Correspondence (Leave one empty box between each unit of Address like House No., Street Name, Post etc.)
11. Tehsil 12. District
13. State 14. Pin Code 15. Mobile No. (for SMS Alerts)
16. Medium of Study 17. Gender 18. Category 19. Domicile 20. Nationality 21. Person with Disability
22. Religion 23. Special Category 24. Marital Status 25. Employment Status
26. SUBJECT OPTION :
B.A./B.Com. Students are required to fill in three optional (elective) subjects. B.Sc. students are required to select any one of the optional (elective) subject
group. B.Ed. students are required to select any one of the optional (elective) subject group. B.Ed. students are required to select any two optional (Teaching)
subject. Refer to the prospectus for details.
1. _________________________________________________________________________________________________
2. _________________________________________________________________________________________________
3. _________________________________________________________________________________________________

1 - Male
2 - Female
3 - Third Gender
1 - General 4 - OBC
2 - SC 5 - SBC
3 - ST 6 - Any other
1 - Indian
2 - Others
1 - Urban
2 - Rural
1 - Loco motor 4 – Mental Retardation
2 - Low Vision 5 – Mental Illness
3 - Hearing 6 – Multiple Disability
1 - Hindu 4 - Christian 7- Parsi
2 - Muslim 5 - Jain 8 - Jews
3 - Sikh 6 - Budhist 9 - Others
1 - Ex-Serviceman 4 - Not applicable
2 - Kashmiri Migrant
3 - War-Widow
1 - Married 4 - Divorcee
2 - Unmarried
3 - Widow
1 - Employed
2 - Unemployed
3 - VMOU Employee/Wards
27.COURSE OPTION :
Write the Course Code and Credit in relevant box. Refer to the prospectus for details.
28. Relevant Qualifications (Which makes you eligible for the programme)
29. Experience in related field (In years)
30. Declaration by Applicant
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 fulfill the minimum eligibility
criteria and I 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. Further, I have carefully read and
understood the rules of the University as printed in the Prospectus and I accept them and shall not raise any dispute in the future over the same rule.
Date :__________________
Place :__________________
Full Signature of the Applicant
Checklist (Please tick √ in relevant box)
Photograph and self signature in appropriate Box
Challan for Programme fee with Name & Form No. overleaf
Attested Certificates and Mark sheets of relevant qualifications
Age Certificate
Experience Certificate (Wherever Applicable)
Category Certificate
Physically Handicapped Certificate
Widow/Divorcee Certificate
Ex-Service man/Kashmir migrant/War widow Certificate
Examination form
MBA student should attach entrance test score card
For office use only
Form checked, found Eligible/Not Eligible for Admission.
Signature : Dealing Assistant Section Officer Regional Director
Emp. Code :
S.No. Course Code Credit
S.No. Course Code Credit
8
9
10
11
12
6 13
5
4
3
2
1
7 14
EXAMINATION PASSED Board/University
01 - Middle/8th
02 - Matriculation/SSC/10th
03 - Intermediate/HSC/10+2/Equivalent
04 - Diploma in Engineering
05 - Graduation in Engineering Year of Passing Division/Grade Marks Obtained Total Marks Percentage
06 - Graduation (Three Year Degree)
07 - Post Graduation in Engineering
08 - Post Graduation or Equivalent Subjects (Leave one box empty between each subject)
09 - MBBS/BHMS/BAMS/BPT/B.Sc.Nursing
10 - BAP/BCP/BSCP from VMOU
11 - No formal Qualification but have attained 18 years of age
INSTRUCTIONS
Fill up separate form for due papers/courses of various Examinations.
Write in CAPITAL LETTERS only within the box. Please read carefully the instructions given overleaf before filling up the form.
8. Name of the Candidate (Leave one empty box between First Name, Middle Name and Surname)
9. Address for Correspondence (Leave one empty box between each unit of Address like House No., Street Name, Post etc.)
10. City 11. District
12. State 13. Pin Code 14. Mobile No. (for SMS Alerts)
15. COURSE OPTION :
Course Codes for which appearing for the first time or failed in the earlier TEE including Practical Courses. Examination fee schedule and Instructions are given overleaf. A
Student shall not be allowed to appear in an examination for more than 54 Credits in Bachelor’s Degree Programme(s) and 56 Credits in Master Degree Programme (s).
Fees will be deposited in account of VARDHAMAN MAHAVEER OPEN UNIVERSITY, KOTA.
16. FEE DETAILS (Only to be paid by defaulter students for Due Papers)
Bank TR/JR No. Total No. of Courses Amount Rs.
TR/JR No. Date
Challan Amount
\
Issuing Bank
VARDHAMAN MAHAVEER OPEN UNIVERSITY, KOTA
(Formerly – Kota Open University, Kota)
EXAMINATION SECTION
RAWATBHATA ROAD, KOTA (RAJ.) – 324021
Term End Examination June / December 20____
EXAMINATION FORM
Serial No.
Control No.
1. Scholar No.
(New admission leave blank)
2. Programme Code
3. Regional Centre Code 4. Study Centre Code
5. Examination Centre City
(Fill your Choice)
6. Medium of Examination (HINDI/ENGLISH/Any other permitted language)
7. Examination Centre Code (Leave Blank, To be allotted by Examination Section)
PHOTOGRAPH
Affix your latest passport size
photograph
SIGNATURE
Put your Signature within the
box given below
S.No. Course Code Credit
S.No. Course Code Credit
8
9
10
11
12
6 13
5
4
3
2
1
/
7 14
Theory Courses
Practical Courses
LATE FEE ₨
TOTAL FEE ₨
X ₨
/
X ₨
DETAILS FOR SUBMISSION OF EXAMINATION FORM
Students For JUNE TEE FEE For DECEMBER TEE FEE WHERE TO SUBMIT
Regular With Admission Form Nil With Admission Form Nil Concerned Regional Centre
Defaulter 1 April to 30 April Without Late Fee 1 October to 31 October Without Late Fee Controller of Examination, VMOU,
Rawat Bhata Road, Kota 1 May to 10 May With Late Fee 1 November to 10 November With Late Fee – 324021 (Raj.)
Term End Examination
SCHEDULE OF EXAMINATION FEE
PROGRAMMES FEE LATE FEE
BAP/BCP/BScP
Certificate
Diploma
Bachelor Degree
₨ 100/- (Per Course/Paper)
₨ 100/- (Per Course/Paper)
P.G. Diploma
Master Degree
Management
₨ 150/- (Per Course/Paper)
₨ 150/- (Per Course/Paper)
EXAMINATION CENTRES
RC Code Regional Centre City
1 AJMER Ajmer, Bhilwara, Niwai, Beawer
2 BIKANER Bikaner, Suratgarh, Sriganganagar, Hanumangarh
3 JAIPUR Jaipur,Itarna (Alwar), Dausa, Rajgarh, Dholpur,
Jhunjhunu, Sikar, Alwar, Neem Ka Thana, Bharatpur, Kotputli, Chomu
4 JODHPUR Jodhpur, Barmer , Pali, Falna, Jaiselmer, Jalor, Balotra, Sirohi
5 KOTA Kota, Bundi, Baran, Sawai Madhopur, Chhabra, Jhalawar, Karauli
6 UDAIPUR Udaipur, Dungarpur, Banswara, Nathdwara, Pratapgarh, Chittorgarh, Sajjangarh
Exam Centre Suratgarh and Itarna (Alwar) is reserved for Defence personnel and their dependents
DLIS & BLIS Exam will be held at scheduled Exam centers under concerned Regional Centre
INSTRUCTIONS FOR FILLING UP THE EXAMINATION FORM
1. Please write correct course code(s) as indicated in Prospectus, failing which the course(s) will not be included in the Permission Letter and Hall Ticket for
appearing in Examination.
2. In case wrong/invalid course code is mentioned in examination form, the course will not be included in the Permission letter and Hall Ticket and the
examination fee will not be refunded.
3. Defaulter student should fill separate form for Due papers of various Examination.
4. Please send the examination form by Registered/Speed Post and retain the proof of its mailing till you receive the Hall Ticket.
5. Term End Examination result is also available on the University website (www.vmou.ac.in or www.vmouonline.in). Please see the result status before filling
examination form.
6. It is advised to enclose/forward only the Examination Fee along with this form. Any other fee forwarded with this form will result in rejection of the
examination form.
7. Examination form received without examination fee or late fee (if applicable) will similarly be rejected.
8. A Student shall not be allowed to appear in an examination for more than 54 Credits in Bachelor’s Degree Programme and 56 Credits in Master Degree
Programme.
9. Fees will be deposited in the account of VARDHAMAN MAHAVEER OPEN UNIVERSITY, KOTA.
10. Examination Permission letter/Hall Ticket should be downloaded from the University website, One week before the commencement of examination.
Student should report at the Examination Centre with VMOU Identity Card.
11. University reserves the right to change the Examination Centre.
12. Change of Examination Centre, once allotted is not permissible under any circumstances.
DECLARATION BY STUDENT
I hereby declare that I have read and understood the instructions given above. I also affirm that I shall submit all the required number of assignments as
applicable for the course(s) filled in the examination form and that my registration for the course(s) is valid and not time barred. If any of my statements is found
to be untrue, I shall have no claim for taking examination. I undertake that I shall abide by the rules and regulations of the University.
Date :__________________
Place :__________________ Full Signature of the Student
Checklist (Please tick √ in relevant box)
Challan for Examination fee.
Photograph & Signature in appropriate box.
Full Signature with Date & Place in DECLARATION BOX.
For office use only
Form checked, found Eligible/Not Eligible for Term End Examination
Signature : Dealing Assistant Section Officer Assistant Registrar
Emp. Code :
130
Guidelines for filling in the Application Form for Admission
(Deposit the fee through Challan Only, Demand Draft will not be entertained)
Please fill up the form in English only and submit the same, in person or by post along with copies of
attested certificates, to your Regional Centre, so as to reach on or before the prescribed last date.
Incomplete application form and those received after the last date will be rejected.
Here are some specific instructions that will help you in filling in the application form. The instructions
are aimed at getting correct and accurate information from you so that you do not face problems
while filling it.
Instructions for filling in of Admission Application Form:-
1. Leave this column blank. Scholar number will be filled in by the University Office.
2. For the programme code of the selected programme, refer to the relevant pages of your
prospectus.
3. Fill the name of the nearest Regional Centre, refer to the prospectus.
4. Fill the study centre code of the selected Regional centre, refer to the prospectus.
5. Fill your date of Birth in given format i.e. DD/MM/YY
6. Fill your relevant fee details (JR/TR no.; JR/TR No. Date; Issuing Bank; amount)
7. To fill your name see the correct format: for example, if your name is Kaushal Sharma then
write each alphabet separately in CAPITAL LETTERS in the box provided for and leave a
gap for clarity.
8. Please write your Father’s name in CAPITAL LETTERS . Married women are also required
to write their Father’s name. For example if the Father’s name is Jagdish Prasad Sharma,
then write it in the following format:
9. Please write Mother’s name in English in the boxes in the format mentioned above in the
similar way. Use only CAPITAL LETTERS.
10. Fill in your address for correspondence where you would like to receive your study material
and all other letters. Do not repeat your name and father’s name here.
11. Fill the name of your City.
12. Fill the name of your District.
13. Fill the name of your State.
14. Fill in the correct Pin Code.
15. Fill your 10 digit mobile number.
1 2 / 0 5 / 1 9 8 7
JAGDISH PARSAD SHARMA
KAUSHAL SHARMA
131
16. For serial number 16-25 fill the relevant numeric code in the box. For example for English
write 1 and for Hindi write 2.(follow the same for all)
26. Students of B.A./B.Com./B.Sc. are required to fill in three optional (elective) subjects. B.A./
B.Sc. Students are required to select as per the optional (elective) subject groups. B.Ed.
students are required to select any 2 optional teaching subject
27. The candidate should fill up the relevant Course Code and Credit in the relevant box.
Refer to the prospectus for details
28. Please fill in relevant numeric code of the highest examination passed and fill the details of
required information of the examination passed. Please attach relevant Photocopies (duly
attested) of the mark sheet pertaining to Secondary, Senior Secondary and Graduation/ Post
Graduation whichever is applicable.
29. Fill in the relevant detail (wherever it is applicable) of experience.
30. Declaration by the Applicant should be filled and signed by the applicant himself/herself with
date and place.
Checklist: Before submission of form, check the whole form and tick all the attached documents.
Checklist (Please tick d c in relevant box)
Photograph and self signature in appropriate Box
Challan for Programme fee with Name & Form No. overleaf
Attested Certificates and Mark sheets of relevant qualifications
Age Certificate
Experience Certificate (Wherever applicable)
Category Certificate
Physically Handicapped Certificate
Widow/Divorcee Certificate
Ex-Service man/Kashmir migrant/War widow Certificate
Examination form
MBA student should attach entrance test score card
132
1 2 / 0 5 / 1 9 8 7
JAGDISH PARSAD SHARMA

Axis Bank
Branch......................................
A/C No. :913020025097530
Axis Bank
Branch......................................
Axis Bank
Branch......................................
TR/JR No. of Bank
1.Programme Name
2.Student Name
3.Father's Name
4.Address
5.Fees Amount Rs. ........Words............................
Fees Detail
(a)Course Fee …………………
(b)Exam Fee
(c)Late Fee
(d)Pr Fee
(e)Other Fee
…………………
…………………
at. Exam …………………
…………………
Total Fees
6.Scholar No.
7.Mobile No.
Date ………… Signature of Student
Bank Stamp
Note:- 1. Student can deposit the programme fee in any of the bank
branches in Rajasthan.
2. Fee once deposited will not be refunded.
Vardhaman Mahaveer Open University, Kota
Regional Centre of Student (Please Tick) : Jaipur/Ajmer/Jodhpur/Udaipur/Bikaner/Kota
Session: January/July 201....
Rawatbhata Road, Kota-324021
TR/JR No. of Bank
1.Programme Name
2.Student Name
3.Father's Name
4.Address
5.Fees Amount Rs. ........Words............................
Fees Detail
(a)Course Fee …………………
(b)Exam Fee
(c)Late Fee
(d)Pr Fee
(e)Other Fee
…………………
…………………
at. Exam …………………
…………………
Total Fees
6.Scholar No.
7.Mobile No.
Date ………… Signature of Student
Bank Stamp
Note:- 1. Student can deposit the programme fee in any of the bank
branches in Rajasthan.
2. Fee once deposited will not be refunded.
Vardhaman Mahaveer Open University, Kota
Regional Centre of Student (Please Tick) : Jaipur/Ajmer/Jodhpur/Udaipur/Bikaner/Kota
Session: January/July 201....
Rawatbhata Road, Kota-324021
TR/JR No. of Bank
1.Programme Name
2.Student Name
3.Father's Name
4.Address
5.Fees Amount Rs. ........Words............................
Fees Detail
(a)Course Fee …………………
(b)Exam Fee
(c)Late Fee
(d)Pr Fee
(e)Other Fee
…………………
…………………
at. Exam …………………
…………………
Total Fees
6.Scholar No.
7.Mobile No.
Date ………… Signature of Student
Bank Stamp
Note:- 1. Student can deposit the programme fee in any of the bank
branches in Rajasthan.
2. Fee once deposited will not be refunded.
Vardhaman Mahaveer Open University, Kota
Regional Centre of Student (Please Tick) : Jaipur/Ajmer/Jodhpur/Udaipur/Bikaner/Kota
Session: January/July 201....
Rawatbhata Road, Kota-324021
First Copy - Student Copy Second Copy - University Copy Third Copy - Bank Copy
A/C No. :913020025097530 A/C No. :913020025097530
Branch......................................
Oriental Bank of Commerce
Branch......................................
Oriental Bank of Commerce
Branch......................................
Oriental Bank of Commerce
TR/JR No. of Bank
1.Programme Name
2.Student Name
3.Father's Name
4.Address
5.Fees Amount Rs. ........Words............................
Fees Detail
(a)Course Fee …………………
(b)Exam Fee
(c)Late Fee
(d)Pr Fee
(e)Other Fee
…………………
…………………
at. Exam …………………
…………………
Total Fees
6.Scholar No.
7.Mobile No.
Date ………… Signature of Student
Bank Stamp
Note:- 1. Student can deposit the programme fee in any of the bank
branches in Rajasthan.
2. Fee once deposited will not be refunded.
Vardhaman Mahaveer Open University, Kota
Regional Centre of Student (Please Tick) : Jaipur/Ajmer/Jodhpur/Udaipur/Bikaner/Kota
Session: January/July 201....
Rawatbhata Road, Kota-324021
First Copy - Student Copy
TR/JR No. of Bank
1.Programme Name
2.Student Name
3.Father's Name
4.Address
5.Fees Amount Rs. ........Words............................
Fees Detail
(a)Course Fee …………………
(b)Exam Fee
(c)Late Fee
(d)Pr Fee
(e)Other Fee
…………………
…………………
at. Exam …………………
…………………
Total Fees
6.Scholar No.
7.Mobile No.
Date ………… Signature of Student
Bank Stamp
Note:- 1. Student can deposit the programme fee in any of the bank
branches in Rajasthan.
2. Fee once deposited will not be refunded.
Vardhaman Mahaveer Open University, Kota
Regional Centre of Student (Please Tick) : Jaipur/Ajmer/Jodhpur/Udaipur/Bikaner/Kota
Session: January/July 201....
Rawatbhata Road, Kota-324021
Second Copy - University Copy
TR/JR No. of Bank
1.Programme Name
2.Student Name
3.Father's Name
4.Address
5.Fees Amount Rs. ........Words............................
Fees Detail
(a)Course Fee …………………
(b)Exam Fee
(c)Late Fee
(d)Pr Fee
(e)Other Fee
…………………
…………………
at. Exam …………………
…………………
Total Fees
6.Scholar No.
7.Mobile No.
Date ………… Signature of Student
Bank Stamp
Note:- 1. Student can deposit the programme fee in any of the bank
branches in Rajasthan.
2. Fee once deposited will not be refunded.
Vardhaman Mahaveer Open University, Kota
Regional Centre of Student (Please Tick) : Jaipur/Ajmer/Jodhpur/Udaipur/Bikaner/Kota
Session: January/July 201....
Rawatbhata Road, Kota-324021
Third Copy - Bank Copy
TR/JR No. of Bank
1.Programme Name
2.Student Name
3.Father's Name
4.Address
5.Fees Amount Rs. ........Words............................
Fees Detail
(a)Course Fee …………………
(b)Exam Fee
(c)Late Fee
(d)Pr Fee
(e)Other Fee
…………………
…………………
at. Exam …………………
…………………
Total Fees
6.Scholar No.
7.Mobile No.
Date ………… Signature of Student
Bank Stamp
Note:- 1. Student can deposit the programme fee in any of the bank
branches in Rajasthan.
2. Fee once deposited will not be refunded.
Vardhaman Mahaveer Open University, Kota
Regional Centre of Student (Please Tick) : Jaipur/Ajmer/Jodhpur/Udaipur/Bikaner/Kota
Session: January/July 201....
Rawatbhata Road, Kota-324021
First Copy - Student Copy
State Bank of Bikaner & Jaipur
Branch: ..............................
TR/JR No. of Bank
1.Programme Name
2.Student Name
3.Father's Name
4.Address
5.Fees Amount Rs. ........Words............................
Fees Detail
(a)Course Fee …………………
(b)Exam Fee
(c)Late Fee
(d)Pr Fee
(e)Other Fee
…………………
…………………
at. Exam …………………
…………………
Total Fees
6.Scholar No.
7.Mobile No.
Date ………… Signature of Student
Bank Stamp
Note:- 1. Student can deposit the programme fee in any of the bank branches in Rajasthan.
2. Fee once deposited will not be refunded.
Vardhaman Mahaveer Open University, Kota
Regional Centre of Student (Please Tick) : Jaipur/Ajmer/Jodhpur/Udaipur/Bikaner/Kota
Session: January/July 201....
Rawatbhata Road, Kota-324021
Second Copy - University Copy
State Bank of Bikaner & Jaipur
Branch: ..............................
TR/JR No. of Bank
1.Programme Name
2.Student Name
3.Father's Name
4.Address
5.Fees Amount Rs. ........Words............................
Fees Detail
(a)Course Fee …………………
(b)Exam Fee
(c)Late Fee
(d)Pr Fee
(e)Other Fee
…………………
…………………
at. Exam …………………
…………………
Total Fees
6.Scholar No.
7.Mobile No.
Date ………… Signature of Student
Bank Stamp
Note:- 1. Student can deposit the programme fee in any of the bank branches in Rajasthan.
2. Fee once deposited will not be refunded.
Vardhaman Mahaveer Open University, Kota
Regional Centre of Student (Please Tick) : Jaipur/Ajmer/Jodhpur/Udaipur/Bikaner/Kota
Session: January/July 201....
Rawatbhata Road, Kota-324021
Third Copy - Bank Copy
State Bank of Bikaner & Jaipur
Branch: ..............................
A/C No. : 61187836446 A/C No. : 61187836446 A/C No. : 61187836446