Central University of Orissa, Koraput
(Established Under the Central Universities Act, 2009)
HOSTEL APPLICATION FORM ADMISSIONS – 2013-2014
1. Name of the Candidate:
2. Father’s Name and Occupation:
3. Sex: M F
4. Category:
Gen OBC SC ST
5. Date of Birth:
Date
Month
Year
6. Present Address:
7. Permanent Address:
8. E-Mail ID:
9. Phone No.:
Land Line
Mobile
10. Programme: Integrated M. Sc. Mathematics M.A/M.Sc
English
Oriya
Journalism and Mass Communication
Sociology
Anthropology
Economics
Biodiversity and Conservation of Natural Resources
Education Technology Research Programmes
M.Phi/Ph. D Sociology
Ph. D Anthroplogy
Ph. D Oriya
Ph. D Journalism and Mass Communication
B.Ed (Teachers Education)
Central University of Orissa, Koraput
(Established Under the Central Universities Act, 2009)
UNDERTAKING I hereby declare that the information given by me in Application Form for Hostel Accommodation is true to the best of my knowledge. I hereby undertake to abide by the rules and if the University authorities take any suitable disciplinary action against me for violating of these rules. I will not have any complaint.
Name:
Signature Date: