Admission Application Form Sl. No. Cost of form: Rs. 10/- Stamp size photograph to be affixed TRIPURA UNIVERSITY SURYAMANINAGAR - 799 130 TRIPURA Date of submission........................ Form for Admission to the MA/M.Sc/M.Com Courses (2007-08) A. (I) Subject applied for admission in MA/M.Sc/M.Com course: (II) Mention the Examination Passed BA/B.Sc/B.Com Honours/Major or pass course/equivalent__________________________ B. PARTICULARS OF THE CANDIDATE 1. Name of the candidate (In block letters).................. 2.Address (a) Correspondence Address ....................... ........................ ........................ (b) Permanent Address: ......................... ......................... ......................... 3. Date of birth: D D M M Y Y Y Y (Enclosed self attested photocopy of Age Proof Certificate) 4. Sex: Male/Female : 5. Name of (a) Father: ............... (b) Mother .......................... 6. Whether a member of SC/ST/OBC/P.H/Minority if yes, mention in the given box (Enclosed self attested photocopy of certificate from competent authority) 8. Nationality........ Name of the state to which you belong: ....... (Enclosed self attested photocopy of permanent Residence certificate) 7. Religion:------------------------------- 9. Sports: Whether National Meet participant: Yes/No If yes, Name of the event......position held....year of award (Enclosed self attested photocopy of certificate) 10.Whether employed:Yes/No ........... (If yes, submit 'No objection Certificate' from the Department) 11.(A) Particulars of marks secured by the TDC Honours/Major Including Honours Declared Pass) Candidates: (B) Particulars of marks secured by the TDC (General) Candidates Name of Examination passed Total marks secured & percentage Name of the subject for admission Marks secured & percentage of the subject for admission Year of passing the Examination Name of University (A)BA/B.Sc/B.Com Honours/Major (B)B.A/B.Sc/B.Com Pass or equivalent (Enclosed self attested photocopies of mark sheets and certificates from Madhyamik or Matriculation onwards) 11.Declaration of the applicant: I do hereby; declare that the information's furnished by me are true to the best of my knowledge. However, I give an undertaking that if any error or discrepancy is detected after my admission by the University Authority, my admission is liable to be cancelled at any time during the course of study. Dated: (Signature of the candidate) SPECIAL INSTRUCTIONS 1.Incomplete Admission form in any respect is liable to be rejected.2.Original documents are to be produced at the time of admission. 3.Three copies of recent Stamp Size photograph are to be enclosed (One copy to be affixed on the box of the form) N.B: The list of the candidates selected for admission will be displayed on the Notice Board of the Office ofthe Secretary, FCPG studies, Tripura University. FOR OFFICE USE ONLY Recommended /Not Recommended for (Reason).............................................................................................. Date: Signature of the Head of Department Date of Admission......Roll No... Challan No.......Date....... .............................................................. Signature of the Secretary FCPG STUDIES Sl. No. ACKNOWLEDGEMENT CARD Date:....... Received Admission Form from Shri/Smt. ............for admission into the course of MA/M.Sc/M.Com in the subject............ during the academic session 2007-2008. Signature of the Dealing Assistant,Receiving the application
