KARNATAKA STATE OPEN UNIVERSITYMANASAGANGOTRI, MYSORE-507 006

In Collaboration with

Algol Universal TrustDistance Mode Face to Face Mode Programmes 2012-2013

Application For Admission To……………......................................................................

Study Centre Name : ………….....…………… Study Centre Code :…………………

Admission Cycle: 1st Cycle July 2nd Cycle January

Roll Number :

STUDENT’S PERSONAL INFORMATION (PLEASE FILL IN BLOCK LETTERS)

1. Name : …………………………………………………………………………………………………………......

2. Father/Husband Name : ………………………………………………………………………………………….

3. Mother Name : …………………………………………………………………………………..………………….

4. DATE OF BIRTH : __ __/__ __/__ __ __ __ 5. (As Per Mark Card)

6. SEX: M/ F 7. NATIONALITY :

8. POSTAL ADDRESS OF APPLICANT : ……………………………………………………………………………

………………………………………………………………………………………………………………………

………………………………………………………………………………………………………………………

………………………………………………….………………………………………..……………………………

Pin : …………………………

9. CONTACT NUMBERS (1) OFFICE: ……………………….. (3) MOBILE: ……………………. (with STD code) (2) RESIDENCE: …………………… (4) E-MAIL: …………...…………

10. CATEGORY Tick (√ ) box

11. WHETHER Tick (√ ) box :

KARNATAKA STATE OPEN UNIVERSITYApplNo.

Karnataka Other State

Indian Non Indian

SC ST OBC GENERAL

PHY. CHALLENGE DEFENCE EX. SERVICEMAN

&&

12. Programme OPTED : …………………………. 13. Programme Code: …………………............................

14. Subjects/Papers in which candidate appearing

S.No Subject Code Subject/Paper Name

15. Qualifying Examinations Passed

Examination Passed Board/University Reg No. & Year of passing

Marks obtained

%Of Marks Class Obtained

16. Applicants Profession (√ ) : Full Time/Part Time/Business/Agriculture/Unemployed/Housewife/Retired/Other

17. Fee payment details

S.No TYPE OF FEE AMOUNT (RS.) Fee Paid DD No: ……………………………..

Dated : ___/___/______

Branch of remittance : ……………………… Name of the Bank: …………………………….

Total

&&

Declaration by the Candidate: I acknowledge to have fully read the prospectus and certify that I have understood all the provisions indicated therein. I certify that I am qualified for the Programme as indicated in the prospectus. I hereby certify that all particulars stated by me in application are true to the best of my knowledge and belief. I understand that my admission is liable to be cancelled if I suppress or distort any information furnished in my application. I understand that University reserves the right to modify/ delete the syllabi, Programme structure, rules and regulations, as and when required. I understand fees once paid will not be refunded. I understand that the University reserves the right to cancel the admission without assigning any reason.

Place:Date: Specimen signature

Signature of the Applicant_________________________________________________________________________________________________

Study CentreI certify that I have personally verified the original certificates and the attached documents including DD’s. I certify that the candidate fulfill the eligibility criteria as per Admission Qualification norms prescribed in the prospectus. I shall be held responsible for any kind of litigation with regards to services.

Place: ……………..

Date :…………….. Study Centre Seal Signature of Co-ordinator

(For Office Use Only)

AUTProgramme eligibility (Programme/Semester) ……………………………………………………………..................

Checked by ……………………………………........………. Verified By……………………………………................

KSOUProgramme eligibility (Programme/Semester) ……………………………………………………………………

Checked by ……………………………………………. Verified By……………………………………...

Note: 1. Candidates are required to attach the following documents with this form:a) Attested photocopies of the Certificates/Detailed Marks Cards of the qualifying exams.

b) Crossed DDs

c) Identity Card (Duly filled & photograph pasted by the candidate) and attested by Study Centre co-ordinator

d) Candidates are advised to collect the candidate Copy of the Receipt for Admission from the Study Centre

1. 2.

&&

ADMISSION FORM

KARNATAKA STATE OPEN UNIVERISTY, MYSORE JULY-12-APRIL-13(TRADITIONAL/YEARLY PROGRAM)

NOTE: 1. NO FIELDS SHOULD BE LEFT BLANK. ALL FIELDS ARE COMPULSORY.

2. ALL ENTRIES SHOULD BE MADE IN BLOCK LETTERS ONLY. 3. CANDIDATE SHOULD FILL THIS FORM IN HIS/HER OWN HANDWRITING.

1) Name of the Program……………………………………....Year……….. Specialization…………………………………..

2) Candidate Roll No………………………………………………………………… (Given by KSOU at the time of Registration)

3) Study Centre Code……………………./………………….……/………………………….…………… Name of the Study Centre………………………………………………………………………………..

4) Name of the Candidate……………………………………………………………………………………

5) Father’s Name……………………………………………………………………………………………….

6) Address for Correspondence: ………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………………………...………………..City……………………………………..State…………..…………………………………PIN……………Phone…(0)…………………………………………

7) Subjects/Papers in which Candidate Appearing.

Sr. No. Subject Code Subject/Paper code

8) Demand Draft Details:

DD No…………………...Dated………………………..Bank…….……………………………………. Amount………………………

Date: ………/…………/………… Signature of the Candidate

Verified By --------------------------------------------------- ------------------------ --------------------- STUDY CENTRE SEAL & SIGNATURE AUT KSOU

KARNATAKA STATE OPEN UNIVERISTY, MYSORE DUE/RE-APPEARING FORM

NOTE: 1.) NO FIELDS SHOULD BE LEFT BLANK. ALL FIELDS ARE COMPULSORY.

2.) ALL ENTRIES SHOULD BE MADE IN BLOCK LETTERS ONLY. 3.) CANDIDATE SHOULD FILL THIS FORM IN HIS/HER OWN HANDWRITING.

1) Name of the Program……………………………………....Semester………..….. Appearing for examination……………………..…..…..…..…..…..…..…..…..…..… 2) Candidate Roll No…………………………………………………………………… (Given by KSOU at the time of Registration) 3) Study Centre Code……………………./………………….……/………………………….………………... 4.) Name of the Study Centre…………………………………………………………………………..…..… 5) Name of the Candidate……………………………………………………………………………………… 6) Father’s Name………………………………………………………………………………………………. 7) Address for Correspondence: …………………………………………………………………………………………………………………….. …………………………………………………………………………………………………………………….. …………………………………...………………..City……………………………………..State…………..…. …..…………………………………PIN……………Phone…….. (0)………………………………………… 8) Name of Due/Backlog/Re-Appearing Subject of previous year. SR.NO.

SUBJECT / PAPER CODE

SEMESTER SUBJECT/PAPER NAME

9) Demand Draft Details: DD No…………………...Dated………………………..Bank…….……………………………………. Amount……………………… Date……/…………/………… Signature of the Candidate Verified By ------------------------------------------------------ ------------------------ -------------------------- STUDY CENTRE SEAL & SIGNATURE AUT KSOU

PASTE YOUR

PASSPORT SIZE

PHOTOGRAPH HERE

RE-REGISTRATION FORM

KARNATAKA STATE OPEN UNIVERISTY, MYSORE

JANUARY-JUNE (2013) SECOND CYCLE (SEMESTER MODE)

NOTE: 1. NO FIELDS SHOULD BE LEFT BLANK. ALL FIELDS ARE COMPULSORY. 2. ALL ENTRIES SHOULD BE MADE IN BLOCK LETTERS ONLY. 3. CANDIDATE SHOULD FILL THIS FORM IN HIS/HER OWN HANDWRITING.

1) Name of the Program……………………………………....Semester……….. Specialization…………………………………..

2) Candidate Roll No………………………………………………………………… (Given by KSOU at the time of Registration)

3) Study Centre Code……………………./………………….……/………………………….…………… Name of the Study Centre………………………………………………………………………………..

4) Name of the Candidate……………………………………………………………………………………

5) Father’s Name……………………………………………………………………………………………….

6) Address for Correspondence: ………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………………………...………………..City……………………………………..State…………..…………………………………PIN……………Phone…(0)…………………………………………

7) Subjects/Papers in which Candidate Appearing.

Sr. No. Subject Code Subject/Paper code

8) Demand Draft Details:

DD No…………………...Dated………………………..Bank…….……………………………………. Amount………………………

Date:………/…………/………… Signature of the Candidate

Verified By --------------------------------------------------- ------------------------ --------------------- STUDY CENTRE SEAL & SIGNATURE AUT KSOU

PASTE YOUR

PASSPORT SIZE

PHOTOGRAPH

HERE

APPLICATION FOR ISSUE OF PROVISONAL DEGREE

Date :

TO

The Registrar Evaluation

Karnataka State Open University

Muktha Gangotri , Mysore

Karnataka

Sub : Request for Issue of Provisional Degree

Respected Sir

This is for your kind attention that I am a student of your esteemed University and have completed my ___________________________course.

Through this application I wish to apply for the issue of my Provisional degree.

I have attached my self attested certificates for your kind perusal .

You are requested to kind issue my PROVISIONAL DEGREE and oblige .

Regards

Signature of the Student

Name of the Student

Course

Enrollment No.

Details of Attached Certificates ( Self Attested ) – Please tick mark which ever is applicable

1. Class X Mark card / Certificate 2. Class XII Mark card / Certificate 3. Graduation – Consolidated mark Card 4. Any Other ( Mention )

APPLICATION FOR ISSUE OF MIGRATION CERTIFICATE

Date :

TO

The Registrar Evaluation

Karnataka State Open University

Muktha Gangotri ,Mysore

Karnataka

Sub: Request for Issue of Migration Certificate

Respected Sir

This is for your kind attention that I am a student of your esteemed University and have completed my ___________________________course.

Through this application I wish to apply for the issue of my Migration Certificate.

I have attached my self attested certificates for your kind perusal .

You are requested to kind issue my MIGRATION CERTIFICATE and oblige .

Regards

Signature of the Student

Name of the Student

Course

Enrollment No.

Details of Attached Certificates ( Self Attested ) – Please tick mark which ever is applicable

1. Class X Mark card / Certificate 2. Class XII Mark card / Certificate 3. Graduation – Consolidated mark Card 4. Any Other ( Mention )

1

PÀ£ÁðlPÀ gÁdå ªÀÄÄPÀÛ «±Àé«zÁ央AiÀÄ KARNATAKA STATE OPEN UNIVERSITY

.............gÀ WÀnPÉÆÃvÀìªÀPÉÌ Cfð Application for the Annual Convocation ..........................(C£ÀéAiÀĪÁUÀzÀÝ£ÀÄß ºÉÆqÉzÀÄ ºÁQ Strikeout whichever is not applicable)

¢£ÁAPÀ Date : ................... ÀܼÀ Place : ................................ C sÀåyðAiÀÄ À»/ Signature of the Candidate

ÀÆZÀ£É: C sÀåyðUÀ¼ÀÄ CfðAiÀÄ£ÀÄß vÀÄA§ÄªÀ ªÀÄÄAavÀªÁV CfðAiÀÄ »A§¢AiÀÄ°ègÀĪÀ ÀÆZÀ£ÉAiÀÄ£ÀÄß UÀªÀĤ À®Ä w½¹zÉ.Note : Candidates are informed to read the INSTRUCTIONS printed overleaf before filling this application.

G¥À¹ÜvÀgÀÄ (¥ÀæxÀªÀÄ zÀeÉðAiÀÄ°è GwÛÃtðgÁVgÀĪÀ ÁßvÀPÉÆÃvÀÛgÀ ¥ÀzÀ«ÃzsÀgÀgÀÄ,J¯Áè gÁåAPï «eÉÃvÀgÀÄ, ¥ÀzÀPÀ/£ÀUÀzÀÄ §ºÀĪÀiÁ£À «eÉÃvÀgÀÄ ºÁUÀÄ ¦.ºÉZïr¥ÀzÀ«ÃzsÀgÀgÀÄ)IN PERSON (Ist Class Post-Graduates, All Rank Holders,Medallists / Cash Prize Winners & P.hD Awardees)

C£ÀÄ¥À¹ÜvÀgÀÄ (EvÀgÀgÀÄ):

IN ABSENTIA (all others)

¥ÀzÀ« / Degree : «µÀAiÀÄ / Subject : UÀAqÀ ÀÄ/ Male :

ºÉAUÀ ÀÄ/ Female :

CAPÀ¥ÀnÖAiÀÄ°ègÀĪÀAvÉ C sÀåyðAiÀÄ ¥ÀÆtð ºÉ ÀgÀÄ (PÀ£ÀßqÀ ªÀÄvÀÄÛEAVèµï£À°è)(ªÉÆzÀ®Ä ºÉ ÀgÀÄ, C£ÀAvÀgÀ E¤²AiÀįïì)

Name of the Candidate in full (in Block letters inKannada and English) as per Marks Card (First name,to be followed by initials)

²æÃ/²æêÀÄw

Sri. / Smt.

CAZÉAiÀÄ «¼Á¸À(zÀ¥Àà CPÀëgÀzÀ°è ¸ÀàµÀÖªÁV §gɬÄj)

Postal Address (in Block Letters)

Pin Code

«zÁåyðAiÀÄÄ G¥À¹ÜvÀgÀÄ (In Person) ªÀÄvÀÄÛ C£ÀÄ¥À¹ÜvÀgÀÄ (In Absentia) ¥ÀzÀ« ¥ÀæªÀiÁt¥ÀvÀæ ¥ÀqÉAiÀÄ®Ä F PɼÀPÀAqÀ ZËPÀnÖ£À°è( ) UÀÄgÀÄvÀÄ ªÀiÁr À» ªÀiÁqÀvÀPÀÌzÀÄÝ.

gÀ²Ã¢ ¸ÀASÉå: ....................................... gÀÆ. :....................... ¢£ÁAPÀ : ......................

Receipt No. : ...................................... Rs. :....................... Date : .......................

«zÁåyðAiÀÄÄ PÀgÁªÀÄÄ« ¥ÀjÃPÁë ¤¢üUÉ ZÀ®£ï ªÀÄÆ®PÀ ºÀt ¥ÁªÀw ªÀiÁr CzÀgÀ «ªÀgÀªÀ£ÀÄß F PɼÀUÉ £ÀªÀÄÆ¢¹Please write your challan No. and date

±ÀÄ®Ì ¥ÁªÀw¹zÀ «ªÀgÀUÀ¼ÀÄ Particulars of fee paid

C£ÀÄ¥À¹ÜvÀgÀÄ IN ABSENTIA G¥À¹ÜvÀgÀÄ IN PERSON

zÀAiÀÄ«lÄÖ F PɼÀUÉ CAZÉ «¼Á ÀªÀ£ÀÄß ÀàµÀÖªÁV §gɬÄj. Please write below your postal address.

To, Degree / Subject : Roll No. :

Sri / Smt. .................................................................

................................................................................

...............................................................................

...............................................................................

..................................Pin Code

Telephone/Mobile No......................................

To, Degree / Subject : Roll No. :

Sri / Smt. .................................................................

................................................................................

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...............................................................................

..................................Pin Code

Telephone/Mobile No......................................

To, Degree / Subject : Roll No. :

Sri / Smt. .................................................................

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...............................................................................

..................................Pin Code

Telephone/Mobile No......................................

To, Degree / Subject : Roll No. :

Sri / Smt. .................................................................

................................................................................

...............................................................................

...............................................................................

..................................Pin Code

Telephone/Mobile No......................................

ÀéAiÀÄA zÀÈrüÃPÀÈvÀ

sÁªÀav

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PÀ£ÀßqÀ ªÀÄvÀÄÛ EAVèµï£À°è zÀ¥ÀàªÁV PÀqÁØAiÀĪÁV §gÉAiÀÄ ÉÃPÀÄ

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Telephone/Mobile No......................................

2

(C) vÉÃUÀðqÉAiÀiÁzÀ ¥ÀzÀ« ¥ÀjÃPÉëAiÀÄ «ªÀgÀ (CAwªÀÄ ªÀµÀðzÀ¥ÀjÃPÉëAiÀÄ°è zÀeÉð WÉÆö¹zÀ CAPÀ¥ÀnÖAiÉÆA¢UÉ J¯Áè ªÀµÀðzÀCAPÀ¥ÀnÖUÀ¼À ¥ÀæwAiÀÄ£ÀÄß ®UÀwÛ¹) (PÉÆæÃrüÃPÀÈvÀ CAPÀ¥ÀnÖAiÀÄ£ÀÄß®UÀwÛ À ÁgÀzÀÄ)

(a) Details of Degree Examination passed (Along withprevious year markscards, Photo copy of Final YearClass Declared Marks Card should be enclosed)(Consolidated Marks Card should not be enclosed)

jf ÀÖgï £ÀA.Reg. No.

wAUÀ¼ÀÄ ªÀµÀðMonth Year

(D) ¥ÀjÃPÁë PÉÃAzÀæ(b) Examination Centre

ªÉÄîÌAqÀ «zÁåyðAiÀÄÄ «±Àé«zÁ央AiÀÄzÀ°è ............................. EAzÀ .............................gÀªÀgÉUÉ ªÁå¸ÀAUÀ ªÀiÁr ...........................................¥ÀjÃPÉëAiÀÄ°è .................................................................. zÀ°è GwÛÃtðgÁVgÀÄvÁÛgÉAzÀÄ zÀÈrüÃPÀj¸À¯ÁVzÉ.

Certified that the above Candidate was student of this University from .................... to ....................... and passed .....................Examination in the year ............................

ªÉÄïÁ¢üPÁjUÀ¼À À» / Signature of the OfficerSignature of the Supt./Asst. Registrar

«zÁåyðUÀ¼ÀÄ UÀªÀÄ£À«lÄÖ F «±ÉõÀ ÀÆZÀ£ÉAiÀÄ£ÀÄß N¢ CfðAiÀÄ£ÀÄß sÀwðªÀiÁqÀvÀPÀÌzÀÄÝ

«±ÉõÀ ÀÆZÀ£É:

IMPORTANT NOTE1) Medal winners, Cash Prize winners and Rank holders and Ist Class Post Graduate

Degree holders of MA, M.Com, M.Sc (IT), M.Ed, MLISc, etc (to be present on the

convocation day) and can receive PG degree certificates IN PERSON.

2) Those who have passed in 2012 can also receive PG degree IN ABSENTIA

(Through Post After Three Months from the Date of Convocation).

3) Those who have secured Gold/Cash Prize Winner & Rank Holders in BA, B.Com,

B.Ed, B.Sc (IT), BLISc, BFA can receive degree certificate IN PERSON.

4) Those who have passed BA, B.Com, B.Ed, B.Sc (IT), BLISc, BFA, Diploma

programmes should receive degree certificate IN ABSENTIA only (Through PostAfter Three Months from the Date of Convocation).

1) ¥ÀzÀPÀ §ºÀĪÀiÁ£À «eÉÃvÀgÀÄ, £ÀUÀzÀÄ §ºÀĪÀiÁ£À «eÉÃvÀgÀÄ ºÁUÀÆ gÁåAPï ¥ÀqÉzÀªÀgÀÄ ªÀÄvÀÄÛ 2012gÀ°è

¥ÀæxÀªÀÄ zÀeÉðAiÀÄ°è GwÛÃtðgÁzÀ J¯Áè ¸ÁßvÀPÉÆÃvÀÛgÀ ¥ÀzÀ«ÃzsÀgÀgÀÄ JA.J, JA.PÁA, JAJ¹ì (Ln),

JA.Eqï, JAJ¯ïLJ¸ï¹, JA.©.J, EvÁå¢ «zÁåyðUÀ¼ÀÄ G¥À¹ÜvÀgÁV (IN PERSON) (WÀnPÉÆÃvÀìªÀ£ÀqÉAiÀÄĪÀ ¢£À) ¥ÀzÀ« ¥ÀæªÀiÁt ¥ÀvÀæ ¥ÀqÉAiÀħºÀÄzÀÄ.

2) 2012gÀ°è GwÛÃtðgÁzÀ ÁßvÀPÉÆÃvÀÛgÀ ¥ÀzÀ«ÃzsÀgÀgÀÄ JA.J, JA.PÁA, JAJ¹ì (Ln), JA.Eqï, JA.©.J,

JAJ¯ïLJ¸ï¹, EvÁå¢ «zÁåyðUÀ¼ÀÄ C£ÀÄ¥À¹ÜwAiÀÄ®Äè ÀºÁ (IN ABSENTIA) ¥ÀzÀ« ¥ÀæªÀiÁt ¥ÀvÀæ

¥ÀqÉAiÀħºÀÄzÀÄ (CAZÉ ªÀÄÆ®PÀ WÀnPÉÆÃvÀìªÀ £ÀqÉzÀ ªÀÄÆgÀÄ wAUÀ¼À £ÀAvÀgÀ).3) ©.J., ©.PÁA, ©.Jqï, ©.J¹ì (Ln), ©.J¥sï.J ºÁUÀÆ ©J¯ïLJ¸ï¹ ¥ÀzÀPÀ/£ÀUÀzÀÄ §ºÀĪÀiÁ£À/gÁåAPï

¥ÀqÉzÀ «zÁåyðUÀ¼ÀÄ ªÀiÁvÀæ G¥À¹ÜvÀgÁV (IN PERSON) ¥ÀzÀ« ¥ÀæªÀiÁt ¥ÀvÀæ ¥ÀqÉAiÀħºÀÄzÀÄ

4) ©.J., ©.PÁA, ©.Jqï, ©.J¹ì (Ln), ©.J¥sï.J, ©J¯ïLJ¸ï¹ ºÁUÀÆ r¥ÉÆèêÀiÁ, F «zÁåyðUÀ¼ÀÄ

C£ÀÄ¥À¹ÜwAiÀÄ°è ªÀiÁvÀæ (IN ABSENTIA) ¥ÀzÀ« ¥ÀæªÀiÁt ¥ÀvÀæ ¥ÀqÉAiÀÄ ÉÃPÀÄ (CAZÉ ªÀÄÆ®PÀ WÀnPÉÆÃvÀìªÀ£ÀqÉzÀ ªÀÄÆgÀÄ wAUÀ¼À £ÀAvÀgÀ).

PÀbÉÃj G¥ÀAiÉÆÃUÀPÉÌ ªÀiÁvÀæ / Office Use Only

Registration No. : Date :

ELIGIBILITY LIST

Vol. No.:

D.C. No.:

Despatch No.:

Page No.:

Issued Date :

Date :

Sl.No. :

(E) eÁw/G¥ÀeÁw (£ÀªÀÄÆ¢¹) :

(c) Caste/Category (Indicate) :

J¹ì SC J¸ï.n ST I IIJ II© III J III© ¸ÁªÀiÁ£Àå GM PH

¥ÀqÉzÀ zÀeÉð : Class obtained

3

C sÀåyðAiÀÄÄ ¹éÃPÀj À ÉÃPÁzÀ WÉÆõÀuÁ ªÀZÀ£ÀPÉÌÀévÀB gÀÄdÄ ºÁPÀvÀPÀÌzÀÄÝ.

Declaration to be signed by candidates is detailed inthis application. This should be invariably signed by theapplicant.

C sÀåyðUÀ¼ÀÄ ¹éÃPÀj À ÉÃPÁzÀ WÉÆõÀuÉ

²¥sÁgÀ ÀÄì ªÀiÁqÀ ÁVgÀĪÀAxÀ £À£ÀߣÀÄß .......................¥ÀzÀ«UɹéÃPÀj ÀĪÀ°è £À£Àß zÉÊ£ÀA¢£À §zÀÄQ£À°è ºÁUÀÆ ªÀiÁvÀÄPÀvÉAiÀİ諱Àé«zÁ央AiÀÄzÀ ¸ÀzÀ¸Àå¤UÉ C£ÀÄUÀÄtªÁzÀ jÃwAiÀÄ°è¥ÀæªÀiÁtÂPÀªÁV £ÀqÉzÀÄPÉƼÀÄîvÉÛãÉ. £À£ÀUÉ ÁªÀÄxÁåðªÀPÁ±À«zÀݵÀÄÖ¸ÁªÀiÁfPÀ ¥ÀæUÀwUÀÆ ªÀiÁ£ÀªÀ PÀÄ®zÀ PÀ ÁåtPÀÆÌ ±Àæ«Ä ÀĪÀÅzÁVF ªÀÄÆ®PÀ ¥ÁæªÀiÁtÂPÀªÁV sÀgÀªÀ¸É ¤ÃqÀvÉÛãÉ.

£À£ÀUÉ ¤ÃqÀ ÁVgÀĪÀ ¥ÀzÀ«AiÀÄ zÉ É¬ÄAzÀ £Á£ÀÄ ÉÃgÀĪÀªÀÈwÛUÉ ÀA§A¢ü¹zÀ PÀvÀðªÀåUÀ¼À£ÀÄß ¥ÁæªÀiÁtÂPÀvɬÄAzÀ®Æ JZÀÑjPɬÄAzÀ®Æ ¤ªÀð»¸ÀÄvÉÛãÉAzÀÆ, J¯Áè ¸ÀAzÀ¨sÀðzÀ®ÆèªÀÈwÛUËgÀªÀ ªÀÄvÀÄÛ ¥Á«vÀæöåªÀ£ÀÄß PÁ¥ÁrPÉÆAqÀÄ §gÀÄvÉÛãÉAzÀÆ,«zÉåAiÀÄ£ÀÄß ¤AzÀå GzÉÝñÀUÀ½UÉ §¼À¸ÀĪÀÅ¢®èªÉAzÀÆ,IÄdÄ¥ÀzÀ¢AzÀ «ZÀ°vÀ£ÁUÀĪÀÅ¢®èªÉAzÀÆ F ªÀÄÆ®PÀ¥ÁæªÀiÁtÂPÀªÁV sÀgÀªÀ É ¤ÃqÀÄvÉÛãÉ.

(ªÀÈwÛ¥ÀgÀ ¥ÀzÀ«UÀ¼À£ÀÄß ¥ÀqÉAiÀÄzÀ C sÀåyðUÀ¼ÀÄ JgÀqÀ£ÉAiÀÄ¥ÁågÁªÀ£ÀÄß ºÉÆqÉzÀĺÁPÀĪÀÅzÀÄ)

¸ÀܼÀ : ....................................¢£ÁAPÀ : .................................... C sÀåyðAiÀÄ À»/-

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DECLARATION

I hereby solemnly declare and promise that, ifadmitted to the Degree of ......................... for which Ihave been recommended, I shall, in my daily life andconversation, conduct myself, as befits a member of thisUniversity ; that I shall, to the utmost of my capacityand opportunity, support the cause of morality and soundlearning, and that, as far as in me lies, I shall uphold andadvance the social order and the well being of myfellowmen.

I shall faithfully and carefully fulfill the duties of theprofession to which I may be admitted by virtue ofDegree, that I shall, on all occassions, maintain its purityand reputation and I shall never deviate from the straightpath of their honourable exercise by making myknowledge subservient to unworthy ends.(In case of Non-professional Degrees the 2nd paragraphbe scored off)Place : .....................Date : ...................... Signature of the Candidate

INSTRUCTIONS TO THE CANDIDATES

01.While sending the application to the Registrar(Evaluation) please superscribe on the cover asCONVOCATION.....................................

02.Please enter clearly in BLOCK LETTERS in the placeprovided, the correct Postal Address to which DegreeCertificate and communication, if any, is to be sent.

03.You are required to furnish complete information inthe form, and then affix a Passport size colourphotograph, TWO photos may be placed in separateenvelope and enclosed with the Application.

04.Self attested Photo copies of Marks Cards of all theyears shall be invariably enclosed.

05.Ist Class Post-Graduates, Medallists / Prize winnersand Rank holders only can take their Degree CertificateIN PERSON. All other will be given the DegreeCertificate only IN ABSENTIA.

06.The candidate shall sign in all the places where he/she is required to sign.

07.After payment of the prescribed fee (KSOUExamination Fund Challan) the completed applicationform shall be sent directly to the Registrar(Evaluation), Karnataka State Open University,Manasagan-gotri, Mysore - 570006.

08.Enquires relating to Non receipt of ConvocationApplication will not receive attention in the Universityoffice.

09.Incomplete Applications are liable to be rejectedwithout assigning any reason whatsoever. REFUNDOF AMOUNT IS NOT PERMISSIBLE UNDERANY CIRCUMSTANCES.

10.Candidates who have applied under Inperson Category,if failed to attend the Convocation shall remit an extraPenal Fee Rs. 100-00 for sending the DegreeCertificate by Registered Post.

11. After the Convocation, the Degree Certificate will besent to the eligible candidates (under In absentiacategory), only through Registered Post. If the saidDegree Certificate is returned to the University