Admission Form From KSOU
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Admission Form Karnataka State Open University Manasagang othri, Mysore 1. Name : J VINOD KUMAR 2. Father’s Name : Jayantha Babu 3. Mother’s Name : G C Chandra rabha Man! 4. Gender : Ma"e 5. Date O# B!rth : $%&'%&()*+ 6. Nat!ona"!ty : Ind!an 7. Re"!,!on : -!ndu 8. Caste : .h!,u"a 9. Cate,ory /0C&0.&OBC&GM1 : GM 10. "a2e O# B!rth : Ban,a"ore 11 . Mob!"e Number : 33)4('+*'' 12. 56Ma!" ID : rea2h789!nodumar;,ma!"72om Correspondence & Permanent Address: ● Country : Ind!a ● C!ty : Ban,a"ore ● 0tate : Karnataa ● !n : 4%''<* ● Address (: No: $'= + th Ma!n= 0adananda Na,ar= ● Address $: NG5F 5ast >ayout (<7 Are you !n 0er9!2e ?@es&No: (+7 Date o# Jo!n!n,: (47 O2e Address:
Transcript of Admission Form From KSOU
Karnataka State Open University
Manasagangothri, Mysore
1. Name : J VINOD KUMAR2. Fathers Name : Jayantha Babu3. Mothers Name : G C Chandra Prabha Mani4. Gender : Male5. Date Of Birth : 26/06/19846. Nationality : Indian7. Religion : Hindu8. Caste : Thigula9. Category [SC/ST/OBC/GM] : GM10. Place Of Birth : Bangalore11. Mobile Number : 779510480012. E-Mail ID : [email protected] & Permanent Address: Country : India City : Bangalore State : Karnataka Pin : 560038 Address 1: No: 20, 4th Main, Sadananda Nagar, Address 2: NGEF East Layout13. Are you in Service (Yes/No):
14. Date of Joining:
15. Office Address:
Course Details :
16. Academic Year:17. Course taken : MCADocuments Attached: Birth Certificate (10th marks card)(yes/No) : Yes Degree (Convocation/all semester marks sheets) : Yes (Convocation) Photos : AttachedQualification Details:
18. Last Exam Passed: BSc19. University: Bangalore20. Reg. No: 02BWS0107021. Year of Passing: 200522. Subjects: Physics, Chemistry, Mathematics23. Class: Second24. Marks Obtained: 25. Total Marks Obtained: 26. Percentage: 52.50Declaration:I clarify that all details furnished are correct to the best of my knowledge and belief, in case of my information given being found to be false or any certificate submitted found not genuine, I understand that I will lose my admission and all fees paid will be forfeited, besides being open to other legal action.
Student signature / name as per 10th marks card:
