MB A - Ge ne r a l , MB A - Ge ne r a l , MB A - Ge ne r a l , MB A - Ge ne r a l , MB A - Ge ne r a l ,

I nt egr at ed, Exec ut i ve I nt egr at ed, Exec ut i ve I nt egr at ed, Exec ut i ve I nt egr at ed, Exec ut i ve I nt egr at ed, Exec ut i ve
MCA, MSC( MCA, MSC( MCA, MSC( MCA, MSC( MCA, MSC(I T ) I T ) I T ) I T ) I T )
UNI VERSI TY OF MADRAS
I NSTI TUTE OF DI STANCE EDUCATI ON
nr nr nr nr nrHf; if Hf; if Hf; if Hf; if Hf; if tpz; zg; gg; tpz; zg; gg; tpz; zg; gg; tpz; zg; gg; tpz; zg; gg; gbtk; gbtk; gbtk; gbtk; gbtk; /APPLICATION FOR ADMISSION
M.B.A. General, Integrated, Executive M.B.A., M.C.A., M.Sc. (I.T.)
Name of the Course applied for
ENROLMENT NUMBER (to be assigned by the IDE office / Co-ordinator, Spot Admission Centre)
STUDY CENTRE / SPOT ADMISSION CENTRE
AT WHICH ADMISSION IS MADE
Centre Code Place
Registration Fee : M.B.A. - Executive Course : Rs.1,000/- For all other Courses : Rs.400/-
(Payment should be made either by designated Bank Challan / Demand Draft)
CANDIDATE TO FURNISH ALL THE REQUIRED PARTICULARS BELOW IN CAPITAL LETTERS
Recent Passport
Photograph signed by a
Gazetted Officer /
PRO/AR (IDE) /
Faculty with Seal
ADDRESS FOR COMMUNICATION (WRITE IN CAPITAL LETTERS)
NAME :
S/o, D/o, W/o, C/o. :
Door No. & Street :
Town / Village Post :
District :
State : INDIA
Pin code :
Phone (Res) : Off.
Registered Mobile No.(RMN) : E-Mail
PERSONAL CONTACT PROGRAMME CENTRE
PCP Centre Code Place
6. a) Community (Tick )
1. NAME OF THE APPLICANT
(as given in the certificate in
CAPITAL LETTERS)
8. Physically Challenged (Tick ) 9. Present Occupation
5. Religion (b) Age (c) Sex (Tick) 4. Nationality
7. Mother Tongue
Yes

No
OC

/ BC

/ MBC

/ SC

/ ST
Male

/ Female
2. Name of Father / Mother /
Guardian / Husband
3. (a) Date of Birth
b) Caste
(a) in English
(b) in the Regional
Language
Main Subject
APPLICATION NUMBER
ACADEMIC YEAR 2014-2015
CALENDAR YEAR 2015
A 1
C 1
4
5
Candidate to tick () any one of the appropriate boxes
for Tuition Fee Consession - (Refer to Page No. 18) Differently Abled Prison
10. Are you undergoing any other course in a College or
University? If so, Specify
11. The wards of Defence Personnel / Ex-Servicemen (a) Ward of Defence Service Personnel
should specify as : (b) Ward of Ex-Servicemen : Navy / Army / Air force.
12.
14. Enclosures
(1) ....................................... (3) ................................................. (5) ..............................................
(2) ....................................... (4) ................................................. (6) ..............................................
I hereby declare that all the particulars given above are correct and I agree to abide by all the Rules and Regulations
of the University that are in force from time to time.
Station :
Date : SIGNATURE OF THE APPLICANT
FOR OFFICE USE ONLY
The Admission particulars furnished in the column No. 13 have been duly verified with Originals and the Candidate
is eligible for admission
VERIFYING STAFF
1. Admission / Cancellation Intimation sent on ........................................................
2. Certificates returned to the Candidate on ........................................................
(1) Statement of Marks (2) S.S.L.C Book (3) Conduct Certificate
(4) Birth Certificate (5) Transfer Certificate (6) ..............................
ASST. /ASST. SECTION OFFICER SECTION OFFICER ASSISTANT REGISTRAR
STUDY CENTRE / SPOT ADMISSION CENTRE / PARTICIPATORY INSTITUTIONS / TWINNING PROGRAMME CENTRE / OFFICE
Signature of the Centre Co-ordinator with Seal DIRECTOR
Received the Provisional admission intimation and all the originals submitted by me
SIGNATURE OF THE APPLICANT
WITH DATE
13. DETAILS OF EXAMINATION PASSED
Choosen by the Candidate will
be final and will not be permitted
to change subsequently
a) Project Work b) Two Optional Subjects
S.S.L.C. / 10
th
Std.
Strikeout whichever is not applicable
(State whether it is 10 Years or 11 Years Course)
P.U.C. / Higher Secondary
Strikeout whichever is not applicable
(State Whether it is One Year
or Two Years Course)
BA/BSC/BCom Degree
With main Subject Strikeout whichever is not
applicable (State Whether it is Two Years
or Three Years Course)
(The above statement must be attested by the same Gazetted Officer/Assistant Registrar/
Public Relation Officer (IDE) / Faculty who attested the Photograph)
Examinations passed Name of the Month & Year of Registration Class with Maximum
with Subjects Passing Number Grade/Marks Marks
Board / University School / College
UNIVERSITY OF MADRAS
INSTITUTE OF DISTANCE EDUCATION
COMPUTER CODING SHEET
2. Main Subject chosen
3. ENROLMENT NUMBER (to be assigned by the office)
4. Name of the Candidate (Write in Capital Letters) (a) in English (b) in the Regional Language
5. Name of Father / Guardian / Husband (Write in Capital Letters)
as per entry in the Transfer Certificate
6. Mothers Name (Write in Capital Letters)
7. Date of Birth
9. Address for communication (do not write your name here)
City Pincode
Phone : Registered Mobile No. (RMN) : E-Mail :
1. Course to which admission is sought (Tick () Appropriate Box)
M.B.A.
Integrated
M.C.A. M.Sc. (I.T.)
M.B.A.
Executive
M.B.A.
General
ACADEMIC YEAR 2014-2015
CALENDAR YEAR 2015
A 1
C 1
4
5
Date Month Year
8. Sex Male

Female

(a)
(b)
12. Nationality Indian

Others

13. Region Urban

Rural

14. Religion
15. Caste
16. Community SC

ST

MBC

BC

OC

17. Physically challenged YES

NO

18. Are you employed? YES

NO

19. Centre at which you propose to attend
the Personal Contact Programme classes
20. Centre at which you propose to collect the
study materials (Refer Page No. 60 to 69)
21. Are you a ward of a Defence Service
Personnel ? (Army / Navy / Air Force)
22. Are you a ward of an Ex-service person? Yes

No

23. Tuition Fee Concession Opted ?
(Candidate to tick (

) any one of the appropriate boxes -

Refer Page No. 18) Candidates can avail any one of the concession
Station :
Date : Signature of the Candidate
Affix
Passport Size
Photo
Not to be attested
Admission of Candidates from Other States
Candidates from other states should submit their applications at any one of
the Study Centres of the Institute of Distance Education (IDE), University
of Madras listed in the Prospectus, of the State concerned for admission to
various courses offered by IDE.
Applications received by post from the candidates of other States will
automatically be linked to the IDE Study Centre of the State concerned.
Applications received by post from the candidates of other States where there
is no Study Centre of this Institute (IDE), will be linked to the nearby IDE
Study Centre of the other State and candidates should undergo the courses
offered by this Institute through such allotted IDE Study Centre only.
Name
Code No.
Name
Code No.
Yes

No

Category
Selection of Project Work
or Two Optional Subjects
a) Project Work b) Two Optional Subjects
10.
GROUP - A
1.
2.
GROUP - B
1.
2.
GROUP - C
GROUP - D
GROUP - E
11. For Optional Subjects, choose any two Papers from any one of the Groups for MBA
1.
2.
1.
2.
1.
2.
GROUP - F
1.
2.
GROUP - G
1.
2.
Differently Abled
Prison
To be filled in by the applicant (6 copies of his/her address) and returned with the completed application form
Please note that the admission intimation, original certificates and learning materials will be sent only to this address by Postal Service
USE BALL POINT PEN ONLY. WRITE IN CAPITAL LETTERS
Affix
Passport Size
Photo
Not to be attested
Name : ...................................................................
................................................................................
Address : ................................................................
.................................................................................
.................................................................................
.Mob.No..............................................................................
PIN
Name : ...................................................................
................................................................................
Address : ................................................................
.................................................................................
.................................................................................
.Mob.No..............................................................................
PIN
Name : ...................................................................
................................................................................
Address : ................................................................
.................................................................................
.................................................................................
.Mob.No..............................................................................
PIN
Name : ...................................................................
................................................................................
Address : ................................................................
.................................................................................
.................................................................................
.Mob.No..............................................................................
PIN
Name : ...................................................................
................................................................................
Address : ................................................................
.................................................................................
.................................................................................
.Mob.No..............................................................................
PIN
Name : ...................................................................
................................................................................
Address : ................................................................
.................................................................................
.................................................................................
.Mob.No..............................................................................
PIN
Calendar Year 2015
C 1 5
Academic Year 2014 - 2015
A 1 4

ADDRESS SLIP
M.B.A., General, Integrated, Executive
M.C.A., M.Sc.(I.T.) COURSES
87
TO BE FILLED- IN BY THE CANDIDATES SEEKING ADMISSION TO II/III YEAR OF UG COURSE
Name of the candidate :
Name of the degree for which admission is sought : II / III YEAR OF........................... (WITH SUBJ ECT)..................................
Name of the College last studied :
Name of the University last studied :
Pattern of Education undergone by him/her : 10+2
Pattern of System undergone by him/her : Semester / Non-Semester
DETAILS OF THE FIRST/SECOND YEAR EXAMINATION ALREADY APPEARED & PASSED only:
The above statement must be attested by the Gazetted Officer/Assistant Registrar/Public Relation Officer(IDE)/Faculty
I hereby declare that all the particulars given above are correct and I agree to abide by all the rules and regulations of the University
that are in force from time to time.
Station:
Date: SIGNATURE OF THE APPLICANT
A.S.O. S.O. A.R.
Name of the
papers appeared
& passed
Code of the
subject
Reg. No.
Month & Year of
Passing
Marks for each subject
Maximum Min.pass
Secured
Marks
RESULT
Passed

88
FOR OFFICE USE ONLY
1. Provisional Admission may be given to Second/Third year
2. Exemption of the following papers may be given to the candidate in which already appeared and
passed
Core Courses-Main subjects
First year :
Second year :
Third year :
3. The candidate has to appear for the following papers as prescribed in the prospectus for the year
20 - 20 as per the decision of Chairman BOS
Core Courses-Main subjects
First year :
Second year :
Third year :
4. Rs.500/- may be collected from the candidate towards the fee for Readmission.
5. Rs.750/- may be collected from the candidate towards the fee for Transfer from other University.
6. Rs.100/- may be collected from the candidate towards the fee for exemption
7. May be considered/May not be considered for classification
8. PCP schedule may be sent along with admission intimation
9. Remarks if any:
Asst/ASO (Admn) Section Officer (Admn) Assistant Registrar (UG/PG/LSS)
Thro Eligibility Section
............ may be approved
Asst/ASO(ES) SO(ES) Asst.Regr(Genl) D.R.(Admn)
DIRECTOR
89
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