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    Prist University: Centre For Distance Education

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    nandakumar486
    This document is an application form for admission to Prist University's Centre for Distance Education. It requests information such as the applicant's name, date of birth, gender, nationality, address, contact details, educational qualifications, chosen program of study, payment details, declaration, and signatures. The form also provides instructions on submitting original documents and certificates.

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    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    Prist University: Centre For Distance Education

    Uploaded by

    nandakumar486
    62 views2 pages
    This document is an application form for admission to Prist University's Centre for Distance Education. It requests information such as the applicant's name, date of birth, gender, nationality, address, contact details, educational qualifications, chosen program of study, payment details, declaration, and signatures. The form also provides instructions on submitting original documents and certificates.

    Original Description:

    Dis Education Form

    Original Title

    Dis Education Form

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    This document is an application form for admission to Prist University's Centre for Distance Education. It requests information such as the applicant's name, date of birth, gender, nationality, address, contact details, educational qualifications, chosen program of study, payment details, declaration, and signatures. The form also provides instructions on submitting original documents and certificates.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    62 views2 pages

    Prist University: Centre For Distance Education

    Uploaded by

    nandakumar486
    This document is an application form for admission to Prist University's Centre for Distance Education. It requests information such as the applicant's name, date of birth, gender, nationality, address, contact details, educational qualifications, chosen program of study, payment details, declaration, and signatures. The form also provides instructions on submitting original documents and certificates.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    PRIST UNIVERSITY

    (Under Sec. 3 of the UGC Act 1956)


    Approved by Distance Education Council, Government of India (Letter No. F.No.DEC/PRISTU/TN/Recog/2008/8672 dt. 30.05.2008)

    Form No.

    C E N T R E F O R D I S TA N C E E D U C AT I O N
    Form of Application for Admission
    1. Name of the applicant
    (in BLOCK Letters, as in +2 mark sheet / UG / PG / PG Diploma Certicate)

    4. Date of Birth : Day 5. Sex 6. Nationality : Male : Indian

    Month Female Others

    Year

    7. Place of Birth : 9. Students E-mail ID : 10. Address to which communication is to be sent: (Name not to be mentioned) Line 1 Line 2 Line 3 Line 4 Pin Code Mobile 11. Educational Qualications : 12. Fees Particulars : Bank DD No. Amount : (PRIST UNIVERSITY Share) Bank DD No. Amount : (Study Centre Share) For mode of payment of fee, please refer Page No. 25 of the Prospectus H.Sc. Degree PG Others Phone

    Pa ss

    3. PCP Centre chosen :

    po

    rt

    Si

    2. Name of the Programme applied for :

    ze

    Ph

    ot

    Details of Educational Qualication


    Please provide full details of your educational qualications Examination Passed HSC / Equivalent Degree Post Graduation Others (Specify) Name of the Course Duration Name of the of the Institution / College Course / University Year of Passing Grade / Class Percentage

    Subjects

    Declaration
    I declare that all the information submitted in this application form is correct and complete. I acknowledge that the PRIST UNIVERSITY reserves the right to vary or reverse any decision regarding admission on the basis of incorrect or incomplete information provided by me. I declare further that I had read and understood all contents of this application form and information brochure and that I am bound by all their contents for all purposes.

    Date :
    results are sent to the Centre within one month of ling this form.

    Signature of the Candidate

    Note : Students who have not received their nal examination results at the time of lling up this form should ensure that their nal

    Return of Originals
    Statement of Marks Degree Certicate Provisional Certicate Others

    Received the Originals

    Signature of the Candidate

    For Study Centre Use


    Admitted Yes : Received the fees and handed over the originals to the candidate

    Signature of the Study Centre in-charge Date : Important : Attach the xerox certicates of the candidate along with this application

    Seal of the Study Centre

    For PRIST UNIVERSITY Use


    Admission Details : Admitted Yes : Enrolment Number :

    Signature of the Admission Ofcer

    Signature of Dealing Assistant:

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