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    Application Form DODL

    Uploaded by

    Mirza Asif Baig
    1) The document is an application form for admission to distance learning programs at Hamdard University. It provides instructions for completing the form and lists the information required, including personal details, education history, program of study, and payment details. 2) Applicants are instructed to fill out the form in capital letters using a ballpoint pen and not to staple or pin any documents to the form. Incomplete applications and those without the prescribed fee will not be processed. 3) The form requests information such as name, date of birth, gender, qualifying examinations, employment status, contact details, education history, mother's name, address and a signature declaring the truth of the

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

    Application Form DODL

    Uploaded by

    Mirza Asif Baig
    215 views2 pages
    1) The document is an application form for admission to distance learning programs at Hamdard University. It provides instructions for completing the form and lists the information required, including personal details, education history, program of study, and payment details. 2) Applicants are instructed to fill out the form in capital letters using a ballpoint pen and not to staple or pin any documents to the form. Incomplete applications and those without the prescribed fee will not be processed. 3) The form requests information such as name, date of birth, gender, qualifying examinations, employment status, contact details, education history, mother's name, address and a signature declaring the truth of the

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    1) The document is an application form for admission to distance learning programs at Hamdard University. It provides instructions for completing the form and lists the information required, including personal details, education history, program of study, and payment details. 2) Applicants are instructed to fill out the form in capital letters using a ballpoint pen and not to staple or pin any documents to the form. Incomplete applications and those without the prescribed fee will not be processed. 3) The form requests information such as name, date of birth, gender, qualifying examinations, employment status, contact details, education history, mother's name, address and a signature declaring the truth of the

    Copyright:

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

    Application Form DODL

    Uploaded by

    Mirza Asif Baig
    1) The document is an application form for admission to distance learning programs at Hamdard University. It provides instructions for completing the form and lists the information required, including personal details, education history, program of study, and payment details. 2) Applicants are instructed to fill out the form in capital letters using a ballpoint pen and not to staple or pin any documents to the form. Incomplete applications and those without the prescribed fee will not be processed. 3) The form requests information such as name, date of birth, gender, qualifying examinations, employment status, contact details, education history, mother's name, address and a signature declaring the truth of the

    Copyright:

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

    HAMDARD UNIVERSITY

    (Jamia Hamdard)
    HAMDARD NAGAR, NEW DELHI - 110062
    TION FORM FOR ADMISSIONS
    APPLICATION
    APPLICA
    DIRECT ORA
    DIRECTORA TE OF OPEN AND DIST
    ORATE ANCE LEARNING
    DISTANCE
    (FOR DISTANCE EDUCATION PROGRAMME)

    IMPOR
    IMPORT TANT INSTRUCTIONS: FORM NUMBER :
    1. Read the PROSPECTUS carefully before filling in the form.
    2. Please fill in all the entries in CAPITAL LETTERS using a BALL POINT PEN only
    3. DO NOT STAMPLE/PIN ANY DOCUMENT WITH THIS FORM. (Use Clip)
    4. Application form with incomplete information and without prescribed fee will not be processed.
    5. Write in CAPITAL LETTERS only within the box without touching the lines as shown in the Sample below. (For office use)

    0 1 2 3 4 5 6 7 8 9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Academic Year

    Programme of Study (Write programme Code in the boxes as given in Prospectus)


    1. Programme Code 2. Processing Fee Enclosed 3. Study Centre Choice 4. Employed?

    Rs. (See Prospectus for Code) A1 = Employed


    B2 = Unemployed

    5. Personal Details

    Name (Use CAPITAL LETTERS only


    CAPITAL only.. Leave a blank box between First, Middle & Last Names)

    Date of Birth Region SC/ST Gender State of Domicile Area


    1. RURAL
    2. Urban

    DAY
    DAY MONTH YEAR (See Prospectus for Codes fo rilling in the boxes shown above.)

    Father
    Father’’s Name (Use CAPITAL LETTERS only
    CAPITAL only.. Leave a blank box between First, Middle & Last Names)

    Country Name Permanent Address PIN Code

    6. Qualifying Exam. Details (See prospectus for codes)

    Qualifying Board/University Year of Passing


    Percentage
    Exam Code Code / Appearing

    7. Photograph 8. Write name & Complete Mailing Address with


    Black Ball Point Pen

    Name :

    C/o

    Paste your
    photograph within
    this box Phone No. :
    DO NOT STAPLE 9. Candidate’s Signature
    Candidate’s
    E-mail ID:

    PIN CODE
    10. Details of Examinations Passed

    Name of School / Board/ Year of Percentage


    Examination Subjects
    College & Place University Passing or Grade

    High School
    (Class X)

    +2/Intermediate

    Graduation I year
    (Write the name
    II year
    of the degree)
    III year

    IV year

    Aggregate

    Post-Graduation

    Fazilat

    Any Other

    11. Mother
    Mother’’s Name _________________________________________________________________________________________

    12. Permanent Address ________________________________________________________________________________

    ________________________________________________________________________________

    DISTRICT
    ________________________________________________________________________________

    STATE PIN CODE


    ________________________________________________________________________________

    COUNTRY
    ________________________________________________________________________________

    13. Are you a son/daughter/spouse of Jamia Hamdard employe? YES / NO


    (If yes, a certificate from the Registrar showing the relationship should be submitted in
    the office of the Director
    office Director,, Directorate of Open and Distance Learning personally.)
    personally.)

    14. Details of Draft

    Draft Number & Date Amount Drawee Bank

    DECLARATION BY THE APPLICANT


    ECLARATION
    I ....................................................................... S/o or D/o ....................................................................... declare that the statements given in this
    application form are true to the best of my knowledge. I understand that if any of the statements are found wrong, my admission will
    stand cancelled. If admitted, I will abide by the rules of regulations in force in jamia Hamdard and as amended from time to time and
    pay the prescribed fees.

    Date : Signature : .......................................................................

    Name : .......................................................................

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