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StudentExamForm2024-04-10 21 59 32

The document is an examination application form for a student named Neelam Devi applying to take a compartment exam. It provides details about the student such as personal information, exam details, selected course, fees paid, and a declaration signed by the student.

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kartik1211451003086
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55 views2 pages

StudentExamForm2024-04-10 21 59 32

The document is an examination application form for a student named Neelam Devi applying to take a compartment exam. It provides details about the student such as personal information, exam details, selected course, fees paid, and a declaration signed by the student.

Uploaded by

kartik1211451003086
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Kurukshetra University, Kurukshetra

(Established by the State Legislature Act XII of 1956)


(A++' Grade , NAAC Accredited)

EXAMINATION APPLICATION FORM


(Session - May-2024 Private Compartment)

Application No : KUP-2024/023507 Student Type PRIVATE STUDENT


Exam District Yamunanagar Exam Station I JAGADHRI
Class Name Bachelor of Arts (Annual) Annual / Semester Annual
Year Second Session May-2024 Private Compartment
Exam Type COMPARTMENT Blind/Deaf No
Prev Exam Session May-2023_Full Paper Prev Exam Roll No. 2291202987
KU. Reg. No. 21-PCD-5122 Capacity Appearing Woman
Domicile No. 191092101008370 Domicile Date Sep 06,2021
Student Name NEELAM DEVI Father Name JAI SINGH
Mother Name PINKI DEVI Mobile No 8059993369
Email Id [email protected] Gender Female
Correspondence Address VILLAGE CHABUTRON
Pincode 135102 State HARYANA
District Yamuna Nagar Area Type Rural
Caste Category SC Date of Birth Apr 16,2003
Aadhaar No 472394037082 Religion Hinduism
Student Photo Student Signature

Selected Course for Examination


Sr. No. Course Code Course Name
1 EN42-1 ENGLISH-1

Page 1
Kurukshetra University, Kurukshetra
(Established by the State Legislature Act XII of 1956)
(A++' Grade , NAAC Accredited)

Fees Details of Examination Form


Transaction ID Payment Date Fee Amount QR Code
ZRCOEKLKUVDQXO1 30-Mar-2024 2,000.00

DECLARATION OF APPLICATION FORM

I solemnly declare and affirm that the particulars given above are correct and true to the best of my knowledge and nothing has
been concealed there in.I am eligible for the Examination as per rules and regulations of the University. I have consulted Syllabus,
Scheme, Eligibility conditions etc. and have gone through general rules/instructions of Kurukshetra University, Kurukshetra,

Submission Date : 30-Mar-2024 Signature____________________________

Please Tick Enclosures :


1. DMC of Previous qualification ( 10th /12th /Graduation /Post Graduation).
2. Haryana Domicile Certificate.
3. Certificate for Physically Handicapped.
4. Certificate for SC/ST.
5. NOC Certificate for Defense personnel and KUK Employees.
6. Original Migration Certificate.
Note:
1. Kindly submit the system generated hard copy (.PDF) of the Online Examination Application form duly signed by the
candidate along with the attested/self attested supporting documents as mentioned in the enclosures above to the following
address by hand or by registered post within 10 days from the date of submission of the Online Examination Application
Form.
In-charge, Examination Enquiry
Kurukshetra University, Kurukshetra - 136119
2. The university reserves the right to create/change/abolish the examination centre/(s) at any stage.

Page 2

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