248 IGNOU Common Prospectus

APPLICATION FORM FOR PROVISIONAL ADMISSION

1. Name

2. Programme for which admission is being sought

3. RC Code

4. Qualifications

5. Details of Qualifying Examination, the result of which is awaited OR the result has been declared, but finalmark-sheet and Provisional Certificate awaited.

a) Examination

b) Board/University

c) Expected date of issue of finalmark-sheet/Provisional certificate

(Signature of the candidate)

Note : Provisional admissible is not applicable for International students.

UNDERTAKING

Mr/Ms ................................................................ son/daughter/Wife of ................................................... .

.......................................... ........, understand that my admission to .... ................................. . .. .. . ..programme

commencing July/January ......................................... admission cycle is provisional and is subject to my

qualifying .............................................................. Examination and production of proof of the same (Mark-

sheet and Provisional Certificate/Degree Certificate) by 30th September (for July admission cycle) / 31st March(for January admission cycle).

Further. I hereby accept the conditions that if I fail to successfully complete the qualifying examination or fail toproduce the proof thereof by the prescribed date. the provisional admission given to me will be cancelled,25% of the programme fee forfeited and I will have no claim to pursue the programme in July............./January........................... Admission cycle.

(Signature of the candidate)

Place :

Annexure-II