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For Office use

,KARAIKUDI-630 003

(A State University Re-Accredited with A Grade by NAAC)

(Recognised by Distance Education Council, New Delhi)

APPLICATION FOR ADMISSIONS

[Semester System] for the CALENDAR YEAR 2012

Signatureof the Student

(To be filled in by the Candidate in his/her own handwriting in Block Letters)Course Applied for (Please put mark in the appropriate box)

Medium for MBA (General) (Please Tick)

1. Name of the Applicant with initial (as in Qualifying Certificate in BLOCKletters):

2. Fathers Name :

3. Address for Communication :

Pin code

DIRECTORATE OF DISTANCE EDUCATION

MBA (General)

MBA(International Business)

MBA (Banking & Finance)

MBA (Project. Management)

MBA (Hospital Management)

MBA (Logistic Management)

MBA (Corp. Secretaryship)

MBA (Tourism)

MBA (Education Mgt.)

MBA (HRM)

MBA (Retail Management)

MBA (CorporateManagement)

MBA (TechnologyManagement)

MBA (5 Years Integrated)MCA

MCA (Lateral Entry)

PGDCA

M.S.W. (Master of SocialWork)

Particulars of Demand Draft:D.D.No.__________________ Rs.__________Date:____________Bank_____________________________

TamilEnglish

To be filled in by the Learning Centre:Name of the Centre:

Code No.

AFFIX STAMPSIZE PHOT

AND SIGNIN THE BOX

GIVEN BELOW

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E-Mail ID:

Phone with

STD Code : Mobile:S

4. Sex: 5. Community:

(Attach Community Certificate Xerox copy)

6. Date of Birth: 7. Nationality:

8. Details of Educational Qualifications:

Course

Studied

Name ofthe Degree

MajorMonth &Year ofPassing

Name of theInstitution/College

/University

Percentageof Marks/

Class

Hr.Secondary

UnderGraduatePostGraduate

(Enclose Original and Attested copies of Plus Two/Hr. Secondary and UG/PG ProvisionalCertificate or Degree Certificate duly attested by Gazetted Officer.)Individual Mark Statements will not be accepted

Option for MBA (General/ International Business):

Electives for MBA (General):

I hereby declare that the particulars given above are true. If any of theparticulars furnished are found to be false, I agree to forfeit my admission.

Date: Signature of the Candidate

Note: The following documents must accompany the filled-in application :

1. Original and Copy of Hr. Secondary Mark Statement duly attested by GazettedOfficer.

2. Original and Copy of UG Provisional or Degree Certificate and Markstatementduly attested by Gazetted Officer.

3. Filled-in Student Index Card with stamp size photo affixed.4. Demand Draft for Prescribed fee (Refer to Prospectus)

5. Copy of Community Certificate duly attested by Gazetted Officer (if applicable).

Certified that* Application is scrutinised Admitted / Not

Admitted* Original Certificates are verified and returned* Copies of the certificates duly attested by Gazetted Officer are verified Date of

Admission _________________* Candidate is found eligible

SC

ST

MBC

BC

OC

Date Month Year

Papers

Marketing

Finance Personnel System

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Signature of the Programme Officer with sealASST.REGISTRAR DIRECTOR

Received back the original certificates:

Signature of the candidate

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ALAGAPPA UNIVERSITY, KARAIKUDI-630 003. (Re-Accredited with A Grade by NAAC)

DIRECTORATE OF DISTANCE EDUCATION(Recognized by Distance Education

Council, New Delhi)

Appln.No: Enrl.No:

PROGRAMME:_____________________________________

_____________________

NAME:

DATE OF BIRTH :

Signature of theStudent

ADDRESS: __________________________________________________________________________________________

_____________________________________________

NAME OF THE LEARNINGCENTRE & CENTRE CODE

STUDENT INDEX CARD

AFFIX STAMPSIZE

PHOTOAND SIGNIN THE BOX

GIVEN BELOW