DEFAULTER

VARDHMAN MAHAVEER OPEN UNIVERSITY, KOTA EXAMINATION

RAWATBHATA ROAD, KOTA (RAJ.) - 324021 FORM
APPLICATION FORM FOR DEFAULTER EXAMINATION Control No.

SESSION: JUNE19   265550

1. Scholar No. 167104-070055  

2. Regional Centre BHARATPUR  

3. Fee Details    
Transaction No. : 4487235391123
   Date : 22-04-2019 Amount : Rs. 1200 /-
  Mode : SBI EPAY

4. Name of Applicant : POOJA BHARDWAJ

5. Father's Name : ANIL KUMAR
6. Mobile No. : 8239827922 7. City Choice For Exam : Bharatpur
8. Medium of Exam : Hindi 9. City For Practical :
Examination & Camp
10. Course Option
  SL.NO. PROG CODE COURSE CODE PAPER TYPE
1 MSCCH-F MSCCH-06 TE
2 MSCCH-F MSCCH-07 TE
3 MSCCH-F MSCCH-08 TE
4 MSCCH-F MSCCH-09 TE
       
 
DECLARATION BY APPLICANT/आवेदक ारा घोषणा
I hereby declare that I have read and understood the instructions given above. I also affirm that I shall submit all the required number of
assignments as applicable for the course(s) filled in the examination form and that my registration for the course(s) is valid and not
time barred. If any of my statements is found to be untrue, I shall have no claim for taking examination. I undertake that I shall abide by
the rules and regulations of the University.
I have selected all the Theory/Practical/Project paper(s) for which I would like to appear in the above examination. I do not want to
appear in the Theory/Practical/Project paper(s) not selected by me for the above examination.
 
Date  : 22-04-2019 19:17:49  

Place : 1.39.194.73   Full Signature of the Applicant

Note : Please do not send hard copy of this application form, you may keep this for your record
only.
     
For Office Use Only
 
Form checked, found Eligible/Not Eligible for Term End Examination.
 
 
Signature   : Dealing Assistant Section Officer Assistant Registrar
 Emp. Code : ______________ _____________ ________________

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