UniversityofKerala
UniversityCampus,Kariavattom,Thiruvananthapuram695581.
APPLICATION
MBA(General)and(Tourism)CSSFulltimeProgramme20132015.
SerialNo.
Feeremittedparticulars
Payinslip/DDNo
AmountRs..
Date:..
Reg.No.
(forofficeuse
only)
1.
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4.
6.
8.
9.
NameinFull
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DateofBirth.3.Age..
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Nationality.5.Placeofbirth.
Religion.7.Community.
StatewhetheryoubelongstoSC/ST/OEC..
AreyoueligibleforreservationunderthefollowingcategoryaspertheG.O.
(MS)No.108/2008/H.Edn.dated20.9.2008.
Ezhava
Muslim
LC/SIUC
OBC(christian)
OBC(Hindu)
Physically
handicapped
SportsQuota
BPL(Forward
communityonly)
10. Addressforcommunication:.
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PinPhone..MobileE.mail..
11. PermanentAddress:...
..
.PinPhone.
12. NameandoccupationofParent/Guardian
13. Detailsofthequalifyingexaminationpassed:
A:DegreeB.Branch/Subject.C.University
D.Month&yearofpassing..
E.Division/Class..D.percentageofmarksinaggregate.
14.Detailsofmarkssecuredinqualifyingexamination(specifythesubject/Specialisationalso)
Qualifying
Examination
PartsofExamination
BA/B.Sc/B.Com
Max.Marks
Semester
courses
Markssecured
%ofmarks
GrandTotal
15. Detailsofworkexperience,ifany(Teaching,Research,IndustrialEtc.)
Organisation
Designation&Natureofwork
Period
Declaration
Iherebysolemnlyandsincerelyaffirmthatthestatementsmadeandtheinformation
furnishedintheapplicationformsubmittedbyme,aretrue.
Place:Date:SignatureofApplicant.
CHOICEOFENTRANCEEXAMINATIONCENTRE
(ChooseonlyoneCentreofyourchoice.TheUniversityreservestherighttocancelanycentreiftherearenosufficientcandidates.In
caseifyourcentreiscancelled,acentrewillbeallottedbyUniversity).
1.Thiruvananthapuram
2.Kollam
3.Alappuzha
4.Adoor
5.Trichur
6.Kannur
InstituteofManagementinKerala
UniversityofKerala
UniversityCampus,Kariavattom,Thiruvananthapuram695581.
KUCAT2013
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NAMEOFTHECANDIDATE
REGISTERNUMBER*
DATEOFENTRANCE
EXAMINATION*
REPORTINGTIME*
EXAMINATIONCENTRE*
SignatureoftheCandidate:
Instructionstocandidates:
1. Pleasereportattheexaminationcentre30minutesbeforethecommencementof
examination
2. HallticketsshouldbesubmittedtotheTestAdministratorforverification.
3. CandidatesarerequestedtouseonlyBlackBallpointpenforthetest.
4. Notes,Calculators,Cellphoneandotherelectronicdevicesarenotpermittedinthe
examinationhall.
5. Malpracticesofanysortarenotpermissible.