ALAGAPPA UNIVERSITY

(Accredited with ‘A’ Grade by NAAC)

KARAIKUDI – 630 003.TAMILNADU
DISTANCE EDUCATION
APPLICATION FOR EXAMINATIONS

1. Course : 2. Exam Centre with

Centre Code :
3. Name of the Study Centre : 4. Month & year of Exam :

1. Name of the applicant (in Block letters) :

2. Father’s Name :

3. Sex : M F

4. Enrolment No. :

5. Permanent Address with Pincode :

6. Mobile No :

7. Year/Semester for which you are

appearing (Both Regular and Arrears) :

8. EXAMINATION FEES PAYMENT

Total
DETAILS Details Nos Amount
Rs.
1. Subject(s) fee
a) Amount paid : Rs.
2. Practical(s) /
b) D.D. Number : Dissertation fee

c) Date of payment : 3. Certificate fee

(including Exam
d) Name and place of : Application fee,
Mark Statement fee,
issuing Bank
Provisional
Certificate fee,
9. *Have your paid the course : Yes/No Degree Certificate
fees due to the University fee) to be paid only
during first
appearance.
Station: 4. Late fee

Date: Total Rs.

Signature of the Candidate

Verified by:
CONTROLLER OF EXAMINATIONS
* Those who have not remitted Second / Third year Course fees will not be permitted to appear for the examination

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 10. Subjects in which you are appearing
Title of the Paper
Subject Subject
First year / First semester First year / Second semester
Code code

Second year / Third semester Second year / Fourth semester

Third year / Fifth semester Third year / Sixth semester

(Score out the letters and numerals which are not applicable to you)
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ALAGAPPA UNIVERSITY
(Accredited with ‘A’ Grade by NAAC)
KARAIKUDI – 630 003
DISTANCE EDUCATION EXAMINATIONS, 201
HALL TICKET
(To be filled in by the candidate)
Photo to be
Name of the Candidate : affixed here
Course :
Enrolment Number :
Examination Centre :
SUBJECTS APPEARING (Write the subject code only)

Signature of the Candidate Controller of Examinations

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