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M. S.

Ramaiah University of Applied Sciences


(Private University Estd. in Karnataka State by Act No. 15 of 2013)
University House, Gnanagangothri Campus, New BEL Road, MSR Nagar, Bengaluru - 54
Tel. : +91 80 4536 6666 | Fax: +91 80 4536 6677 | www.msruas.ac.in

ADMISSION REGISTRATION FORM


Regn. No.: Date:
UG Programme: B.Tech. / B.D.S. / B.Design / B.H.M. / B.Pharm. / Pharm.D. Affix
Passport Size
PG Programme: M.Tech. / M.D.S. / M.Pharm. / M.H.A. / M.B.A / M.Com. / Self-a ested
M.Sc. / M.Design / M.B.A. (Hospitality Management) Photograph
PhD: Engineering & Technology / Art & Design / Pharmacy / Dental Sciences
Management / Physics / Chemistry / Mathema cs
I hereby declare that all the informa on furnished above are true and correct to the best of my knowledge and
belief. I'm enclosing the photocopies of marks cards from Class X to qualifying eligibility examina on for
admission to course applied for registra on. I'm aware that in the event of my not qualifying in the
examina on, my registra on will be cancelled and I'll be not be eligible for admission to the course applied.
(Applicable for those candidates who are awai ng for results of the final year and any supplementary results
of back log). Further, I'm aware that in case I do not take admission or do not qualify for admission Rs. 2500/-
will be forfeited as administra on charges and balance will be refunded against my wri en request. I'm also
aware that, mere registra on for a par cular course does not automa cally en tle me to claim a seat. The
confirma on of seat and admission to the chosen course is subject to my fulfilling the eligibility norms of the
University such as entry level qualifica on for admission and obtaining minimum cut off percentage,
submission of full set of original documents of all previous examina on and payment of full annual fee /
course fee (as applicable) within the s pulated me frame of the University. (Cutoff date men oned
hereunder). I agree to regularly watch the University website for cut off dates for admission to all courses.
A er this date no correspondence will be entertained.

I have read and understood the course details, University norms and eligibility criteria for admission from the
University Website www.msruas.ac.in.

Signature of the Student Signature of the Father/Mother/Guardian

FOR OFFICE USE ONLY


Name of the student
Course registered for
Fee received details
Cutoff date & me
Registra on No. and Date

Signature of the Admissions Counsellor Accounts Execu ve

Director of Admissions

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