KRISHNA KANTA HANDIQUI STATE OPEN UNIVERSITY
DEGREE 1ST YEAR EXAMINATION: BA/B.COM./BBA/BMC
SESSION__________ Form No.Ex-14-A
NAME OF THE STUDY CENTRE :
1. Enrolment Number : (as in enrolment certificate)
2. Name of the Candidate : (in BLOCK letters only)
First Name Middle Name Last Name
3. Father’s Name : (in BLOCK letters only)
4. Mother’s Name : (in BLOCK letters only)
5. Complete Address :
________________________________________________________________________________
________________________________________________________________________________
Pin : ______________________Telephone/Mobile No._________________________________
6. Caste (P): General ; SC ; ST ; ST (Hills) ; ST (Plain) ; OBC ; MOBC
7. Sex : Male ; Female ;
8. Subjects to be appeared in Examination :
(i) ________________________ (ii) _______________________
(iii) ________________________ (iv) _______________________
9.Examination Passed: : BPP ; HS (Arts/Commerce/Science)
(Name of Subjects to be written Clearly)
Passport size
photograph
to be
pasted
X
Full signature of
the Candidate
To,
The Controller of Examinations
K.K. Handiqui State Open University
Housefed Complex, Dispur,
Guwahati-6
Sir,
I hereby present myself as a candidate for the ensuing Degree Examination ________________________of Krishna Kanta Handiqui State Open University.
If any of the statements made and particulars furnished in the application is found to be not true or if it appears that in the opinion of the University, I have contravened any of the provisions of the rules and regulations of the University relating to the Degree examination, my admission to the Examination will be liable to be cancelled.
The fees shown hereunder are forwarded herewith --
Programme Examination fee Marksheet fee Centre fee Total
B.A. 600/- 50/- 200/- 850/-
B.Com 750/- 50/- 200/- 1000/-
BMC 750/- 50/- 200/- 1000/-
BBA 600/- 50/- 200/- 850/-
Yours obediently
Date : (Full signature of the candidate )
CO-ORDINATOR’S CERTIFICATE
I certify that the candidate named above is a duly enrolled student in Degree programme
(___________________________Course)of this Study Centre and that --
1. He/she has completed the requirements to appear in Degree Examination.
2. His/her conduct has been good.
3. He/she has filled in the particulars himself/herself and put his/her signature in the application in my presence and I believe the subjoined accounts are true.
4. I know nothing against his/her moral character.
5. He/she has not availed of more than 4 chances of appearing in Examination.
Date : Seal Signature
Name :
Co-ordinator
Accepted/ Not accepted
OSD (Examination)