Page 1 of 3
CENTRAL UNIVERSITY OF KASHMIR
Transit Campus: Sonwar, Srinagar – 190 004 RAGGING IN ANY FORM IS A PUNISHABLE OFFENCE
ADMISSION FORM (Academic Session 2016-2017)
Programme : _________________________________________________________
Department : _________________________________________________________
School : _________________________________________________________
Name of the Applicant as in Matriculation Certificate ( Leave a blank box between each part of name )
Father’s / Husband’s Name ( Strike out whichever is not applicable )
Permanent Address ( Leave a blank box between each unit of address like House No., Street No. )
City/District State
Pin Code
Address for Correspondence (if different from 6)
Telephone No. (if any with STD Code) : Mobile
e-mail address
Date of Birth Day Month Year
Category : ________
Merit rank : ________
Enrolment No.
CUCET_ID : ________
Entrance Test Score (70%) : ________
Qualifying Marks (30%): ___________
Group Discussion : ________
Personal Interview : ________
Total : ________
Paste your duly attested recent photograph here
1 2
4
5
6
7
8
Form No.
3
Page 2 of 3 Gender: Male Female
Nationality: Indian Other (specify) ___________________________________ _____________
Category: General OBC SC ST PwD
Monthly income of the Father/Guardian ______________________________________________
Educational Qualifications:
(Starting from Matriculation. Attach attested photocopies of Diploma/degree certificates along with marks sheets)Programme Fee Details:
(Please write your name & Enrolment No. at the back of the Demand Draft) Draft No./ University Receipt No.
Amount Date
Issuing Branch (in case of draft)
Payable at SRINAGAR
Documents to be submitted:
Certified that all the documents required for the purpose of applying for admission to this university are Complete in all respects.
S. No. Description Tick (if applicable) Tick (if submitted)
1. Attested photocopy of Matriculation Certificate bearing D.O.B 2. Attested photocopy of marks sheet of the qualifying examination 3. School Leaving Certificate / Migration Certificate / Character Certificate 4. Two additional recent passport size photographs
5.. Reservation certificate (if applicable). OBC Candidates should also attach a declaration that the selected students do not belong to any creamy layer.
6. Others, if any, specify
Whether Hostel facility required or not:
Yes NoIf yes, please fill up the enclosed format.
Details of the fee receipt:
Draft No./ University Receipt No.
Amount Date
Whether Transport facility required or not:
Yes NoIf yes, please fill up the enclosed format.
Details of the fee receipt:
Draft No./ University Receipt No.
Amount Date
Disciplinary History
Have you ever been subjected to disciplinary action by any school, college or University you have last attended, or convicted of any criminal case
or otherwise of a violation of any law: Yes No
Level University/
Board
Year of passing
%age
Marks/CGPA Subjects
Matric 10+2
Bachelor’s Degree Other’s Specify ( if any)
9
1 11 12
14
15
16
18 10
13
17
Page 3 of 3 Note: The applicants are required to file on-line anti-ragging undertaking on website www.antiragging.in
and enclose a hard copy of the same with this form as an essential pre-requisite.
DECLARATION BY THE CANDIDATE
I solemnly declare that the statements recorded by me in this application are true and complete to the best of my knowledge and belief and nothing has been concealed. I am aware that if at any stage, it is found that any statement made is not true or incomplete or is misleading, the admission, if made will be automatically cancelled and that I shall not be entitled to refund of any fee paid by me to the University. Further, I shall abide by the rules & regulations of the University in letter and spirit.
Further, I hereby declare that I will not involve myself in any activity which falls within the definition of ragging as it is a punishable offence under the Supreme Court guidelines and the standing instructions in force in this behalf. The requisite undertaking filed online on www.antiragging.in is enclosed.
Place: Signature of the Candidate
Date :
Signature of Official Incharge of Admissions Name _____________________________________
Designation ______________________________ ______
