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VARDHMAN MAHAVEER OPEN UNIVERSITY, KOTA ADMISSION FORM

(Formerly - Kota Open University, Kota) Registration No.
RAWATBHATA ROAD, KOTA (RAJ.) - 324021 814587
ADMISSION cum EXAMINATION FORM
Application No.
SESSION: July  2019

1. Scholar No.             -             (For Office Use Only)

2. Programme : DLIS/Diploma in Library and Information Science

3. Regional Centre : JODHPUR 4. Study Centre : 4000
Code
5. Date Of Birth : 16 Jul 1997 Age as on 01 July  2019
(Attach Certificate)   21 Year(s), 11 month(s), 16 day(s)
6. Fee Details   Prospectus Fee : ₹ 100
  MO No. : 814587 Registration Fee : ₹ 100
Development
TR/JR/Token No. : 7584051305312 Fee
: ₹ 100
  TR/JR/Token : 05 Aug 2019 Course Fee : ₹ 2000
Date Postal Charges : ₹ 100
  Issuer : SBI EPAY Theory Exam Fee : ₹ 1200
  Amount : ₹ 3600 /- Practical  Camp Fee : ₹ 0   Practical Exam Fee : ₹ 0

7. Name of Applicant : RAJHANS

8. Father's Name : ARJUN SINGH
9. Mother's Name : PUSHP KANWAR
10. Address for : PLOT NO 123 GOKUL NAGAR OPPOSITE JODHPUR CANTT BANAR ROAD
Correspondence JODHPUR
11. City : JODHPUR 12. District : JODHPUR
13. State : RAJASTHAN 14. Pin Code : 342015
15.  Mobile No.  : 7014164933 16. Medium of Exam : Hindi
17. Gender : Female 18. Category : General
19. Domicile : Rural 20. Nationality : INDIAN
21. Person with Disability : No 22. Religion : Hindu
23. Special Category : Not Applicable 24. Marital Status : Unmarried
25. Employment Status : Unemployed 26. Aadhar No./Voter ID/ : 641181735462
Pan Card No./Driving
License
/Bhamashah Card
27. Email ID : rajhanskanwar93@gmail.com
28. Subject Option
  Not Applicable
29. Course Option
  COURSE
SL.NO. SUBJECT NAME COURSE NAME CREDIT
CODE
Pustkalya Vargikaran evam Suchikaran
1 Not Applicable DLIS-01 6
Siddhant
2 Not Applicable Pustkalya Vargikaran -Prayogik DLIS-02 6
 3 Not Applicable Pustkalya Suchikaran -Prayogik DLIS-03 6
4 Not Applicable Pustkalya Nityacharya evam Sandarbh Karya DLIS-04 6
5 Not Applicable Vidhayalay evam Sarvjanik Pustkalya DLIS-05 6
6 Not Applicable Suchna Sevayein evam Computer Anuprayog DLIS-06 6
      Total Credit: 36
30. Relevant Qualifications     
  Examination Passed : Graduation or Equivalent
Board/University : JAI NARAIN VYAS UNIVERSITY, JODHPUR
Year of Passing : 2017 Marks Obtained : 979/1800
Division/Grade : Second Percentage : 54.39
Subjects : PUBLIC ADMINISTRATION , HISTORY, SOCIOLOGY
31. Experience in related field : 0  (In Months)    
32 Exam City : Jodhpur 33. Practical Exam/Camp City :
34. Declaration by Applicant      
DECLARATION BY APPLICANT/आवेदक ारा घोषणा
I hereby declare that I have read and understood the conditions of eligibility for the programme for which I seek admission. I fulfill the
minimum eligibility criteria and I have provided necessary information in the regard. In the event of any information being found
incorrect or misleading, my candidature shall be liable to cancellation by the University at any time and I shall not be entitled to refund
of any fee paid by me to the University. Further, I have carefully read and understood the rules of the University as printed in the
Prospectus and I accept them and shall not raise any dispute in the future over the same rule. In case of any dispute the place of
Jurisdiction will be the kota city only.
 

     
Date  :: 27-07-2019 12:35:00  
Place : 157.37.154.13   Full Signature of the Applicant
     
  Checklist (Please √ in relevant box)
  Original Photograph & Full Signature in appropriate box given in DECLARATION BY APPLICANT
Challan for Programme fee with Name & Registion No.
Self Attested Certificates and Mark sheets of relevant qualifications
Age Certificate
Experience Certificate (Wherever Applicable)
Category Certificate (Wherever Applicable)
Physically Handicapped Certificate (Wherever Applicable)
Widow/Divorcee Certificate (Wherever Applicable)
Ex-Service man/Kashmiri migrant/War widow Certificate (Wherever Applicable)
MBA student should attach entrance test score card
   
  नोट : ऑनलाइन फॉम क हाडकॉपी व व ालय म जमा करवाने क आव यकता नह है | आवेदन प क त/हाडकॉपी
अपने अ भलेख / रकॉड् स म रख |
For Office Use Only
 
Form checked, found Eligible/Not Eligible for Admission.
 
 
 Signature   : Dealing Assistant Section Officer/Assistant Registrar Regional Director
Emp. Code : _________________ _____________________ ______________________

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Additional Information regarding DLIS/Diploma in Library and Information Science  by Prof.
(Dr.) HARI BABU NANDWANA  Convener/Coordinator

There is no record available.

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