Central University of Orissa, Koraput
(Established Under the Central Universities Act, 2009)
APPLICATION FORM FOR ISSUE OF IDENTITY CARD
ADMISSIONS – 2013-2014
I request that I may be issued an identity card. I submit the following details for the same.
Name
Course in which Studying
Registration No
Date of Birth
Residential Address
Contact Telephone Number
Blood Group
I attach two copies of my recent photograph (Stamp size). Date: Signature of the Student Recommended by: (Signature of Head/IC)