Category:

General / SC/ST

INSTITUTE OF HUMAN RESOURCES DEVELOPMENT

(Established by Government of Kerala)

Admission to the Colleges of Applied Sciences(IHRD) under M.G. University

Application for admission to B.Sc Degree Programme
in Computer Science/Electronics & B. Com with Computer Application/Taxation
to the Colleges of Applied Sciences(IHRD) under M.G. University during 2016-17.
(for Office use only)

Registration
fee remitted

Register No:

Receipt No.
& Date

Note: 1. Read the Prospectus & Instructions carefully before filling up the Application Form.
2. The Application form duly filled in should be sent to the Principal of the College where the applicant desires to get
admission. Submit separate application form for each college .

1. Name of the College where admission is sought :

College of Applied Sciences,....

2. Name of the applicant :

(in Block letters, Initials at the end)

3. Sex (M/F)

4. Nationality :

5. Nativity ( Keralite or Non-Keralite):

6. Date of Birth ( As in SSLC book/card) :
7. a) Address for Communication :

b) Valid Email id :
c) Land phone :
d) Mobile(s) :
(Memo will be send by email only)

8. a) Name of Father :
b) Name of Mother :
c) Annual Family income :
d) Name of Guardian (if parents are not alive) :
9. Contact details of Parents/Guardian
a) Land line :
b) Mobile :
c) email :
10. Details of Qualifying Examination passed
a) Name of Examination :
b) Number of Chances :
c) Reg.no and Year of Examination. :
d) Optional Subjects :
e) Name of Examination Board. :
f) Name of the institution studied with State.:
11. Do you belong to any other community eligible
for reservation as per prospectus? Write Yes or
No. If Yes, write (1) Community:
(2) Annual family income:

12. a) Category (SC/ST/OEC) :

b) Name of Community :
c) ADHAAR No.
:
(Attach copy of community certificate)

13. Name of THSS, in case the applicant has passed

Plus Two course from a THSS managed by
IHRD.
14. Whether dependant of an Ex-Service man
(Attach copy of relevant certificate/Discharge certificate)

15. a) Details of certificate in NCC( in the Plus two level

b) Grade Certificate :

(Attach copy of the certificates)

16. Details of certificate in NSS ( in the Plus two level )

(Attach copy of the certificate)

17. Are you eligible for local reservation? If yes,

Name of the panchayath / Taluk in which the
educational institution is situated, from which
you have passed the qualifying examination
(attach the certificate from the school)

18. Options for Branch of Study :

(Enter options in the order of your priority)

1.
2.

Options : BSc-CS,
BCom (CA),

BSc-EL,
BCom (Taxation)

3.
4

22. Details of the Marks in the Qualifying Examination . (Attach

copy of the Mark list.)

a) Qualifying Exam. Passed. :

(Plus two/CBSE/ISC/VHSE)

b) No. of chances for Pass :

c) Total Score for Part III Optional

Grade

Marks Secured

Maximum marks

i)
ii)
iii)
iv)
Total
Marks obtained in part III as per prospectus conditions less marks for handicapped + marks for Commerce subjects
(max 150 marks, Min 50 marks in each of the three subjects of Commerce combination)

23. Photo copies of documents attached : (Please write Y/N in the box)
a) Plus Two/CBSE/ISC/VHSE certificate
b)
c)
d)
*

e) Grade Certificate in NCC

SSLC
f) Certificate in NSS
Community certificate(for SC/ST/OEC candidates)
g) Nativity certificate (if required)
Certificate in NCC
h) Adhaar card
Original certificates need to be produced at the time of Interview only.

Declaration
a) I/We hereby solemnly and sincerely affirm that the information furnished in my application
and all the enclosures are true and correct.
In case, any information furnished in the
application or attached documents are found to be incorrect, I realize that I am liable to
criminal prosecution and also agree to forgo my admission.
b) I/We have fully read the conditions for admission to College of Applied Sciences, as contained
in the prospectus and I agree to abide by them.
c) I understand that memo for interview will be send by email only and intimation for chance
interview will be given through telephone number provided in this application only. I declare
that the email id & phone number given in this application is correct and active.
d) I/We have read and understood the cardinal points of Ragging Prevention Act include in the
prospectus. I/We shall fully abide by the provisions and directions in the Act.
e) I declare that I have not involved in any ragging incident or convicted under section 4 of
Kerala Prohibition of Ragging Act 1998, during the previous period of three years.
f) I/We agree to abide the campus rules of the College. I understand that use of personal
conveyance other than bicycle in the campus is prohibited. I also understand that the
use/possession of any type of mobile phone within the campus is prohibited and liable for
disciplinary action, if found violating the rules.
g) I/We have fully read the condition for issue of Transfer Certificate given in the prospectus and
agree to pay fee for remaining semesters as mentioned in the rules, in case of discontinuing
the course.

Sign. of Parent/Guardian :

Signature of Applicant :

Place :
Date :

Place:
Date :

(For Office use only)

Eligibility for quota.

THSS

SC/ST

Admission No. :

Date:

OEC

2016 IHRD. All rights reserved.

Branch :

Other