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59 views5 pages

application-bped

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Uploaded by

tinykidff
Copyright
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MAHATMA GANDHI UNIVERSITY

KOTTAYAM, KERALA
APPLICATION FOR ADMISSION TO BPEd PROGRAMME 2024-25 IN St. JOSEPH’S
ACADEMY OF HIGHER EDUCATION AND RESEARCH, MOOLAMATTOM
1. Name of the candidate (in block
letters)
2. Name of the candidate (in
Malayalam)
3. Expansion of initials
4. Mobile Number
5. Gender
6. Age and date of birth Nationality

7. Place of birth Taluk District State

8. Permanent Home Address with


Mobile No.

9.Address to which communication e-mail(compulsory):


should be sent

Tel. No. Mob. No.

10. Name and address of parent or


guardian
(State relationship)

11. Occupation and annual income of


parent or guardian

12. Name and address of Local


Guardian, if any
13. Religion and Caste (candidates
belonging
to SC/ST/SEBC/OEC categories
should
attach the copy of caste certificate)
14. Academic Qualifications: Statement of Marks Secured in the Qualifying Examination
(Attach copies of the Mark lists/Certificates)
Name of Name of Subject Marks Maxim- Percentage Year of
Examination University/Institution Secured um of marks passing and
Passed Marks secured Reg. No.
SSLC
HSC/+2

Degree
Any other
(Specify)

15. Achievements in sports


Name of Dist./State/University/ Position Year of Remarks
Sports Institution Represented secured participation
activity

16. Achievement in NCC, NSS, etc.


(attach true copies of relevant certificates)

17. Whether eligible for bonus marks under


Defence Category

18. Details of scholarship/fee concessions,


if any, availed of by the applicant
19. Any other qualification or information
(attach copies of relevant certificates)

20. Details of Application fees


Online Receipt Number Date Amount (Rs.) Remarks

21. Attach true copies of documents by post 1. Application Form


and scanned copies to email in the
2. Online Receipt
following order (Please tick the relevant
items) 3. Mark lists of qualifying exams
4. Certificate showing achievement in
sports, games, etc.
5. Caste Certificate
6. Income Certificate
7. Other Certificates/documents, if
any(specify)

DECLARATION

I …………………………………………….. do hereby declare that the statements


made in the application are true and the documents attached herewith are the copies
of the original in my possession, which will be produced for verification when
required. I have read through the prospectus and I accept the terms and conditions
mentioned therein.

Place:
Date : Signature of the Applicant

Countersigned
by the Parent/Guardian

For Office use only


Remarks :
Date of Admission :
Admission Num
Annexure
MEDICAL CERTIFICATE
(To be certified by Registered Medical Practitioner)

1. Name :
2. Sex :
3. Height :
4. Weight :
5. Physical appearance :
6. CNS :
7. CVS :
8. Respiratory System :
9. Liver :
10. Spleen :
11. Hernia sites :
12. Throat :
13. Ears perforation/discharge:
14. Hearing :
15. Speech :
16. Vision :
17. Any other abnormality/deformities (Such as Kyphosis, Lordosis, Scoliosis, Knock
knees, Flatfoot, Obesity, etc):
18. History of Epilepsy, Asthma, TB, VD, Allergy, etc:

Certified that I have carefully examined Sri./Kum. … … … … … … … … … … …


… … … … … … … … … … … … … … … … … aged … … … … … … … and recorded
my observations as above.
I certify that he/she is fit/not fit to undergo training in physical education and
sports, which involves strenuous physical activities.

Signature of the candidate: Signature of the Doctor:


Name:
Reg. No:
Address:
School of Physical Education and Sports Sciences
MAHATMA GANDHI UNIVERSITY, KOTTAYAM

PHYSICAL FITNESS TEST 2024

With reference to your application for admission to the BPEd Programme, you
are directed to report at 9.00 am at St. JOSEPH’S ACADEMY OF HIGHER
EDUCATION AND RESEARCH, MOOLAMATTOM for the written examination,
physical fitness and game proficiency test on 15.06.2024.You must also bring sports
kits for physical fitness and game proficiency test. You are also required to bring all
certificates along with sports achievements certificates in original for verification.

Place: P.D Hills


Date: DIRECTOR

*Candidates must submit 2 passport size photos at the venue above mentioned.
*Candidates must collect the Admit Card from the venue on the exam date.

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