KARNATAKA STATE OPEN UNIVERSITY
Manasagangotri, Mysore – 570 006, Karnataka, India
&
Academic Collaborator
SCOPE, Bangalore - 24
RE-REGISTRATION FORM FOR SESSION ______YEAR_____EXAMINATION
1. Enrollment No. / Roll No. of the Student(Given by KSOU at the time of Registration)
COURSE APPLIED FOR
Course : Stream :
Semester :
2. Study Centre Code : SF/KSOU/
3. Name of the Candidate
4. Father’s Name/ Husband’s Name
5. Address for Correspondence :-
City State Pin
Contact Number E-Mail
6. Papers Opted 1.
2.
3.
4.
5.
6.
Date:............................................... Signature of the Candidate
STUDY CENTRE
This is to certify that candidate have paid the fees as per the dates notified in University approved academic calendar.
SCOPE, Bangalore - 24
Verified By................................................................. Verified By.................................................................
KSOU
Specialization/Elective
Note:- 1. No Fields Should Be Left Blank, All Fields Are Compulsory
2. All Entries Should Be Made In Block Letters Only
3. Submit Your Re-registration Form On Or Before Dates Mentioned On University
Website (www.ksoukarnataka.com)
4. Candidate Should Fill This Form In His/her Own Handwriting .
7.
8.
9.
Date:-................................................. Signature of the Signatory (Seal)
Affix a passport
size photograph
duly signed by the
candidate
7. Demand Draft Details
D.D Number
D.D Date
Amount
Name of the
Bank
-
APPLICATION FOR ADMISSION TO_________________ PROGRAMMES 2011-2012
Enrolment No. (For office use only)
Affix a passport
size photograph
duly signed by the
candidate
KARNATAKA STATE OPEN UNIVERSITY
Manasagangotri, Mysore – 570 006, Karnataka, India
&
1. Name of the Applicant as in the Marks Card of Standard X exam :
2. Father’s / Husband’s Name :
3. Mother’s Name :
4. Date of Birth : 5. Sex : 6. Nationality :
Date
M F
Month Year
7. Mother tongue :
8. Complete Address of Student for Correspondence (Do not repeat name) :
( )
Examination Passed Month & Year
of Passing
Subject Percentage
of Marks
Name of the
Board/University
14.Educational Qualification (10th Onwards) :
SCOPE, Bangalore - 24
City State Pin
Contact Number E-Mail
13. Demand Draft Details
D.D Number
D.D Date
Amount
Name of the
Bank
9.Study Centre Code : Name of the Centre : City or Town :
11.Course Applied For : Stream : Sem : Year :
Specialization/Elective
10. Regulation - R1 R2 BPP MPP
12. OPTIONAL PAPER ( FOR BA COURSE) 1. 2. 3.