in collaboration with rajyoga education & research ... · annamalai university in ......
TRANSCRIPT
2. Name in CAPITAL LETTERS (In English): (as in Educational certificate)
3. Father’s Name / Husband’s Name in CAPITAL LETTERS (In English):
PASSPORT SIZEPHOTO
duly signedand attested
by an authorisedOfficer
APPLICATION NO.
ROLL NO.
FOR OFFICE USE ONLY
Dist.
State
Phone No.(with STD Code)
PIN
E-mail ID Mobile No. :
6. Date of birth (in the Christian era) (as entered in the School Leaving Certificate)
7. Sex: Male Female 7. Nationality:
8. Religion: Hindu Muslim Christian Others (specify)
9. Community:
Date Month Year
91
SC ST MBC BCM DNCSCA BC OC
ANNAMALAI UNIVERSITY
In Collaboration with
1. Programme 2 1 3 Hypnotherapy Code & Name
Counselling and
Medium : ENGLISH
4. PERMANENT ADDRESS IN CAPITAL LETTERS (to which communications and lessons are to be sent)
Rajyoga Education & Research Foundation, Madurai
APPLICATION FOR ADMISSION TO
Reg. No.and Year
Percentageof Marks
ClassObtained
Name of theExamination
Name of theUniversity/Board
Duration ofProgramme
10. Qualifying Examination Passed:
Application Fee : Rs. 100/ - in person and Rs. 150/- by post
Academic Year : 2015 - 2016
PG Diploma in
Place:
Date: Signature of the Applicant
i) I declare that the particulars given above are correct and I submit myself to the disciplinary and regularly jurisdiction of the authorities of
the University who are vested with the rights to exercise discipline under the Act, the Statutes, and the Ordinances, and will strictly observe
the rules and regulations that have been framed thereunder by the University.
ii) I hereby agree that with regard to disputes arising in all matters including admission, returning of original certificates after verification,
sending of lessons, classes, response sheets, examinations, remittance of fees, etc., only the Courts and Tribunals having jurisdiction over
Annamalainagar (Chidambaram), Cuddalore District, Tamilnadu and not over any other place, shall have jurisdiction for the purpose of filing a
suit or preferring complaint under the Consumer Protection Act or any other law for the time being in force or for taking any legal action against
the Co-ordinator (Oncampus Programmes), D.D.E., Campus or the Controller of Examinations, Annamalai University.
DECLARATION
12. Occupation: Government Non-Government Others
13. Are you presently undergoing any
other programmes, in any institution Yes No
(including DDE)? If yes, give details :
Official-in-Charge The Programme Co-ordinator The Programme Director
Official-in-Charge Section Head
Admission Confirmed
11. Pattern of passing 11+1+311+2+2 10+2+3
(Direct OUS, UG, PG Degree are not Eligible)the Degree Examination:
Enclosures: (1) Photostat Copy of (Check List)
Degree Certificate/Pass / Provisional Certificate
(2) Photostat Copy of Mark List or Consolidated Mark List
(3) Photostat Copy of Transfer or Migration Certificate
(4) Identy Card duly filled in
(6) Photo Copy of Community Certificate (Except OC)
(5) Scanning Slip
(Do not enclose original certificates)
REMITTANCE PARTICULARS
2) Transfer OR Migration Certificate Draft/Challan Number :
3) Mark List (10th/12th Standard) Amount :
FOR OFFICE USE ONLY ELIGIBLE NOT ELIGIBLE
Provisionally selected for admission. Spot selection subject to confirmation by the Director
Name of the Bank :1) Degree/Provisional/Pass Certificate
Date :4) 8th Standard Transfer Certificate
5) 10th Standard Transfer Certificate
CERTIFICATES VERIFIED
Co-ordinator(On-Campus Programmes)
CHECK LIST
While sending filled up Application please ensure the following :
1. For PG Diploma VE&S / M.B.A/M.Sc.,(2 Years)/ PGDVIHC/PG Dip in Counselling & Hypnotherapy
a) One Degree Certificate (Xerox copy duly attested by a Gazetted Officer, either provisional or Degree Certificate).
b) Final Mark sheet consolidated / 3 Years Mark sheet (Xerox copy duly attested by a Gazetted Officer)
c) One Certificate to verify your name and Date of Birth (Xerox copy of Transfer Certificate /10th or 12th Mark sheet
duly attested by a Gazetted officer).
For Diploma in VE&S
a) One +2 or equivalent Certificate/Mark sheet (Xerox copy duly attested by a Gazetted Officer)
b) Transfer Certificate to verify your Date of Birth (Xerox copy of duly attested by a Gazetted officer)
For M.Sc.,(L.E))
a) PGDVE&S Provisional/Convocation and Mark sheet (Xerox copy duly attested by a Gazetted Officer)
2. One Passportsize photograph to be affixed and duly attested by a gazetted officer on the application form.
Two passport size photos should be enclosed along with the application.
3. Demand draft favouring The Director,DDE,Annamalai University payable at Chennai from any bank.
For Diploma in VE&S Rs.2500/‐
For PG Diploma in VE&S Rs.4500/‐
For M.Sc.,(L.E) Rs.8500/‐
For M.Sc.,(1st year) Rs.4500/‐
Please don’t forget to write your name & Course code on the back of the DD drawn .
4. Please send your application along with the enclosures to the following address and not directly to the
Annamalai University.
The Admission Division, AU Nodal center, Brahma Kumaris,RE&RF, 36,Meenakshi Nagar, MADURAI – 625017. Mob: 09442268660. 5. The university will confirm the receipt of the application form through SMS,if you provide your Mobile number.
M.B.A Rs.14500/‐
PG Dip.in Values in
Healthcare
Rs. 4500/‐
PG Dip.in Counselling &
Hypnotherapy
Rs. 6500/‐