12 September 2015

16:31

ADMISSION FORM
2015 - 2016
Prospectus Number /
(A) Programme Details /

Study Center Code /

S005

Study Center Name /

UNIVERSITY MAIN CAMPUS ALLAHABAD

Programme Code /

201

Medium /

Nature of Programme /

Annual

(B) Personal
Details /

Name of Programme /

MASTER OF ARTS -ECONOMICS

Reg. No. 2511773274

Signature of Candidate(in
the box)

Year of Admission /

Enrollment No. (Only

for IInd and IIIrd Year
Students)
(
f}rh;

1st Year

10

Name of the student /

LOKRANJAN CHAUBE

(English)
11

Name of the student

(in Hindi) /
(

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12

Father's Name /

RAM POOJAN CHAIUBE

(English)
13

Father's Name (in

Hindi) /
(

14

Mother's Name /

SHOBHA DEVI

(English)
15

Mother's Name (in

Hindi) /
(

16

Date of Birth /

12 August 1995

17

Category /

GEN /

(Put a tick mark

OBC /

ST /

SC
0

in the appropriate box)

18

Gender /

Male /

Female /
Transgender /

19

Physically
Challenged? (If yes
Mention Category) /

Yes

No

Orthopedic Visual Hearing

(
)
20

Religion /

Hindu Muslim Sikh Christian Jain B

uddhist Parsi Others

21

Territory /

Rural Urban

22

Nationality (Mention
the country in case of
others) /

Indian Others

(
)
23

Mobile Number /

24

Permanent Address /

District /
State /
Pin
: ..........
: ......... Code
.....
.......

25

Mailing Address /

District /
State /
Pin
: .........
: ......... Code
.....
.......

Note: All
communications will
be done on this
address.

8175913479

(C) Fee Details /

26

Mode of Fee Payment /

Online Banking

27

E-Challan No. / -

2513733175

28

E-Challan Payment Date / -

2015-09-12 16:24:02

29

Payable Bank /

On-line Banking

30

Transaction No /

414655695

31

Branch Code /

IG0AREDPW7

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31

Branch Code /

IG0AREDPW7

32

Fee Amount(In Rupees) /

7000.0 /-

(D) Academic
Qualification /
Name of
Examination /

Board /
University /

Passing
Year /

Subject /

Percentage
(%) /
(%)

Marks /
Max

/fo'ofo|ky;

Obtaine
d

Division /

High School or
Equivalent /
Intermediate /
Graduation /
Post Graduation
/
Others /

(E) Course /
1 . Compulsory Core
Course /

Sr. No.

Paper
Number /

Course Code /

Title of Course /

5076

MAEC-01

5077

MAEC-02

5078

MAEC-03

Paper Credits /

2. Discipline-Centric Elective
Course( Please select any
One) /
(

Sr. No.

Paper
Number /

Course
Code /

Title of
Course /

Paper
Credits /

5079

MAEC-04

5080

MAEC-05

Paper
Number /

Course
Code /

Choose
Paper /

3. Open Elective Course (Other

Disciplines)( Please select any
One) /
(
Sr. No.

)
Title of
Course /

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Paper
Credits /

Choose
Paper /

2828

M.Com.-04

387

MASY-12

5064

MAPS-04

5158

MASW-03

Total Credit of First Year

40

Declaration by the Candidate

The information given in this Online Form is True and Correct to my knowledge and belief. I fulfill the eligibility
conditions required for admission to the academic programme, I have applied for. In case something otherwise
becomes known about me the University can cancel my admission and I will not claim refund of the fee
deposited. The University can also initiate disciplinary action against me as per University rules.
Place............................ Date............................. Candidate's
.
.
Signature................................................................
Study Center Verification
I have verified the original documents submitted by the students including Fee details. The candidate fulfills the
eligibility criteria as per the prescribed norms of the University.
Checked and Forwarded by Co-ordinator with seal

This is computer generated report. Generated on 12 Sep 2015 04:30

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