Part I

Part II

Part III (excluding FC.NSS etc.)

Major / Main

Ancillary / Allied I

II

14. Details of other PG courses applied for in this University

13. Details of Qualifying Examination(U.G Level) Passed Yet to Pass *

11. Address for Communication

10. Annual Income of the Family Rs.

8. Number of Members in the Family

7. Community

4. Gender

3. a. Name of Father/Guardian and Occupation

b. Name of Mother and Occupation :

2. Name (In block letters) (as in the SSLC Mark Sheet)

1. Course Applying for Application No. : PG / 2016 - 17

5. Date of BirthMALE FEMALE

Whether belonging to OC/BC/BCM/MBC/DNT/SC/ST/SCA/Others State (Enclose attested Xerox Copy of the Community Certificate)

9. Details of Registration Fee Rs.

OC BC BCM MBC SC SCA ST

Date:

DD/Challan No.& Date

Bank :

Phone No.:

e-mail ID :

Phone No.:

e-mail ID :

Mobile No.:

12. Permanent Address

a. Degree & branch of study

b. Name of the College

c. Name of the University

d. Register Number

e. Month & Year of Passing

15. Extra curricular activities :

.................................................................

.................................................................

........................................................

.................................................

SubjectsMarks obtained upto

V sem / II year Max. Marks Percentage of Marks

thRe - Accredited by NAAC with “A” Grade - Awarded 14 Rank by MHRD - NIRF, Govt. of India.Application for admission to Post - Graduate / PG Diploma Courses during 2016 - 2017

Bharathiar University, COIMBATORE - 641 046.

6.Native state

Please give all the information asked for, clearly indicate, ‘not applicable’ wherever necessary.The filled in application should reach the respective Heads of the University Department,

Bharathiar University, Coimbatore - 641 046 on or before 20-05-2016, 5.30 pm.

Affix a Passport sizePhotograph attested by

the candidate

Prospectus2016 - 2017

28

Signature of the attesting officerName and designation of the attesting officer with seal

Attested

Class in Part III Total in Part III

*Strike out whichever is not applicable

Station :

Date :Signature of the Candidate

I certify that all the above statements and entries are true.

Part I :

1.

2.

3.

4.

DETAILS OF SUBJECTS AND MARKS OBTAINED IN THE QUALIFYING EXAMINATION UPTO V SEM. / II YEAR

Part II :

1.

2.

3.

4.

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

22.

Class in Part I

Class in Part II

Total in Part I

Total in Part I

Part III : (Main, Elective & allied / ancillary subjects) - upto V sem. / II year

SubjectsNo. of

AttemptsMarks

securedMax.

Marks% of

Marks

INDEX CARDAppln. No. : PG / 2016 - 17

Name (in block letters as in SSLC Mark Sheet)

Address for sending Hall Ticket

*Strike out whichever is not applicable For office use only:

Signature of the Applicant

Eligible / Not eligible

Percentage of Marks in Part III(upto V Sem. / II Year)

Ancillary & Main AlliedMajor subjects:

Degree :

Community :

Indicate the State to which you belong :

Mobile :

Month & Yearof completion

University :*Passed/yet to pass

PIN :Gender Male / Female

Course applied for

Duration Year(s) :

Passed / Yet to pass

OC BC BCM MBC SC SCA ST

%

Date :

P.T.O.

Head of the Dept.

(with seal)*To be filled in by the candidate

* Name of the Candidate :

* Course for which application is submitted

*Specimen Signature of the Candidate

The candidate is requested to report at the test centre one hour before the commencement of the

test and present this Hall Ticket. The Candidate is permitted to write the entrance test, subject to the

condition that he/she satisfies the Eligibility conditions presscribed for admission to the course.

thRe - Accredited by NAAC with “A” Grade - Awarded 14 Rank by MHRD - NIRF, Govt. of India.

Entrance Test for Admission to the P.G. Programme 2016 - 2017

Phone : +91-422-242222 Fax : +91-422-2452706 Webiste : www.b-u.ac.in

HALL TICKET

Bharathiar University, COIMBATORE - 641 046.

Bharathiar UniversityRe - Accredited by NAAC with “A” Grade

thAwarded 14 Rank by MHRD - NIRF, Govt. of India.

COIMBATORE - 641 046

Affix a Passport size

Photograph attested by

the candidate

Prospectus2016 - 2017

30

Address to which the Hall Ticket is to be sent:

Date :

Time :

Exam. Centre :

Register No. PG / 2016-17 /

ToTo

Name :

Address :

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Pin : ...................................................................................................