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Cost of Application Rs.15 + Registration Fee Rs.35 + Entrance Test Fee Rs.100 = Total Rs.

150/-

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NOTE : Please fill this ICR Sheet in ENGLISH with CAPITAL letters only.
Read the Instructions overleaf carefully before filling this form.

For Office Use Only

Application Number

1. Course Applied

Registration Number
2. II Language Code
T- Telugu, S-Sanskrit,
H-Hindi
3. Medium of Instruction

E - English; T - Telugu

Batch

Year

(See Prospectus for avaiability)

AY

4. Choice of Study Centre Code (See overleaf for codes)


I Priority

II Priority

CY

III Priority

5. Name of the Candidate and Father's Name (CAPITAL LETTERS ONLY) as per SSC or its equivalent examination /Notary
Name
of the
Candidate
FOLD ALONG THE DOTTED LINE

Father's
Name
6. Sex

7. Marital Status

Day
M = Male
F = Female

Notary

8. Date of Birth as per SSC


Month

M = Married
U = Un-Married

Year

9. Reservation
Category Code

10. Identification Marks (Moles) in CAPITAL LETTERS only


1.
2.

11. Address for Communication


C/o
Paste recent
Passport size
Photograph ONLY
within this box.

Door No. /
House No.
Street/Village

Do not staple / pin &


Do not sign on
the Photograph

Mandal/Town
PIN Code

District
Phone
(if any)

STD Code

Phone No.

Mobile No.
(If any)
E-mail ID : ______________________________________
CDE will send important messages through SMS, if Mobile Number is given.

Signature of the Candidate


(inside the box above)

INSTRUCTIONS AND EXAMPLES TO FILL IN THE ICR APPLICATION FORM


1.
2.
3.
4.

This ICR Application is designed for computerization purpose and it should be handled carefully. It should not be mutilated or folded.
Mutilated or folded forms will not be accepted.
ICR Application should be filled properly within the box and legibly by the candidate in his/her own handwriting with ball pen Blue or Black
in CAPITAL LETTERS only. The Candidate himself / herself must sign in the box provided.
Please do not overwrite on the ICR sheet.
Only good quality recent passport size photograph should be pasted on the ICR Application Form. Please do not staple or pin the
photograph. Please do not sign on the photograph pasted on the ICR Application Form. Attestation should not be done on the photograph.

1. Course Applied For example : B.A. (English, Politics, Public Administration)


Course Name

Course Code

B.A. (Economics, History, Politics) ...............................


B.A. (Economics, Public. Administration, Politics) ........
B.A. (Economics, Public Administration, Sociology) ....
B.A. (Economics, History, Sociology) ..........................
B.A. (Economics, Politics, Sociology) ..........................
B.A. (History, Politics, Sociology) ................................
B.A. (Public Administration, Politics, Sociology) ..........
B.A. (Public Administration, Politics, History) ..............
B.A. (Maths, Politics, Economics) ...............................
B.A. (Maths, English, History) ....................................
B.A. (Maths, Telugu, History) .....................................
B.A. (English, Economics, Public Administration) .......
B.A. (Engiish, Economics, Politics) .............................
B.A. (English, History Politics) ....................................
B.A. (English, Politics, Public Administration) ..............
B.A. (English, History, Telugu) ....................................
B.A. (Telugu, History, Sociology) ................................

Course Name
Course Code
B.A. (Telugu, History, Politics) ...........................................
57
B.Com (General) ................................................................
58
B.Sc. (Botany, Zoology, Chemistry) ...................................
59
B.Sc. (Maths, Physics, Chemistry) ....................................
60
B.Sc. (Costume Design & Fashion Technology) ................
61
B.Sc. (Information Technology) .........................................
62
B.Sc. (Maths, Statistics, Computers) .................................
63
Bachelor of Business Managerment (BBM) ....................
64
Bachelor of Hotel Management (BHM) ..............................
65
B.A. (Maths, Economics, Statistics) ..................................
66
B.A. (Maths, Statistics & Computer Applications) .............
67
B.Com. (Computer Applications) .......................................
68
B.Com. (Marketing) ...........................................................
69
B.Com (Foreign Trade) .....................................................
70
B.Sc. (Maths, Physics, Electronics) .................................
71
B.Sc. (Maths, Electronics, Computer Science) .................
72
B.Sc. (Maths, Physics, Computer Science) ......................
73
B.B.A. (Retail Management) ..............................................
75
B.A. (Maths, English, Statistics) ........................................
112

40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56

3. Medium of Instruction ( Refer prospectus)


2. II Language Code
S
For example : Sanskrit
T- Telugu S-Sanskrit H-Hindi

1. Both English medium and Telugu medium for B.Sc


(MPC, BZC).
T
2. Only Telugu medium for BA and BCom Courses.
3. only English Medium for all other B.Sc., BBM, BHM, BBA Courses

For example : Telugu

4. Choice of Study centre Code


For example :
Mahatmagandhi College GUNTUR

E - English; T - Telugu

STUDY CENTRE CODES : Students must contact the study centre before applying for a particular course
Name of the Study Centre
Hindu College, Guntur ...............................................................
Mahatma Gandhi College, Guntur ............................................
Career Degree College, Guntur .................................................
A S N College, Tenali ...............................................................
Vidyakendram Degree College, Sattenapalli ...............................
T R R & S Degree College, Piduguralla ....................................
Modern Degree College, Chilakaluripet ....................................
Ideal & Sri Krishna Chaitanya Memorial Degree College,Markapuram
RRD Degree & PG College, Hyderabad .......................................
Ruthviks Degree College, Vijayawada ......................................
Prabhas Degree College, Vijayawada .......................................
Nalanda Degree College, Vijayawada ......................................
Andhra Jateeya Kalasala, Machilipatnam ................................
K.T.R. Womens Degree College, Gudivada .......................................
S.V. Degree College, Gannavaram ..................................................
SVRK Degree College, Eluru ..........................................................
MSRS Siddhartha Degree College, Visakhapatnam .................
Samyukta Degree College, Anakapalli ......................................
2TCICVJK9QOGPU&GITGG%QNNGIG-WMCVRally, Hyderabad .......
Santhinikethan Degree College, Sattupalli ...............................
Vashista Degree College, Nirmal ...............................................
Sri Vasavi Sarada Junior College, Akividu .................................
Sri Vidya Degree College, Manuguru, Khammam (Dt.)..............
National Degree College, Secunderabad .................................
DAR. College, Nuzividu ............................................................
Sri Vijaya Durga Degree College, Kurnool ...............................
S.R.K. Degree College, Nandyal .............................................
GATE Degree College, Tirupathi .............................................
Aditya Degree College, Kakinada .............................................
Aditya Degree College, Rajahmundry .......................................
Siddardha Degree & PG College for Women, Hyderabad .........
Sri Nagarjuna Degree College, Ameerpet, Hyderabad ..............
Kavitha Memorial PG College, Khammam ..................................
Aditya Degree College, Hanamkonda .......................................
D R Goenka Womens Degree College, Tadepalligudem ...........
Chaitanya E S Degree College, Srikakulam ..............................
Sadhana Degree College, Proddutur ........................................
Smt. & Sri GKRVD Degree College, Rajahmundry ...................
NRT Krishnaveni Degree College, Vinukonda ...........................
JC Degree College, Mandapeta ................................................
AVR Degree College, Avanigadda .............................................
N.B.T. & N.V.C. College, Narasaraopet ......................................

Code

Name of the Study Centre

001
002
003
004
005
006
008
011
012
013
014
016
017
018
019
021
023
024
025
027
030
031
032
035
042
043
044
047
051
052
053
055
057
059
061
062
064
069
070
071
083
084

V.R.S. & Y.R.N. Degree College, Chirala ..................................


Ln. G.V.Rao Modern Degree College, Ramachandrapuram .....
Arya Bhatta Degree College of Arts & Science, Khammam ......
G R R & T P R Degree College, Cumbum ................................
Pragathi Arts & Science College, Atchampet ............................
Nalanda Degree College, Adilabad .........................................
Geetham Degree College, Ongole ..........................................
E.V. Reddy Memorial Degree College, Kodad ........................
V.S.K. Degree College, Bhimavaram .................................................
New Silver Jubilee's Degree College, Hyderabad .............................
KLR Degree College, Paloncha .....................................................
Westin College of Hotel Management, Vijayawada ..........................
BGBS Womens College, Narsapur ..............................................
Sri Balaji Degree College, Vijayawada ...........................................
Sri Subbaraya & Narayana College, Narasaraopeta .........................
Vikas Degree College, Lokumudigaruvu .........................................
Sri Chanakya Institute of Hotel Management & C.T. ........................
Dr. S.R.J. Degree College, Atmakur (Nellore Dist.) .........................
Sri Chalapati Degree College, Eluru ..............................................
Viswa Bharathi PG College of Engineering & Management ...............
Pioneer Institute of Hotel Management, Zamistanpur, Hyderabad ....
Akkineni Nageswara Rao College, Gudivada ..................................
Greenfields College of C.T. & Hotel Management, Hyderabad .........
Chakradhar Degree College, Macherla ..........................................
Chaitanya Degree College for Women, Mancherial .........................
M.S.R. Degree College, Kavali ....................................................
Pragati Degree College, Kakinada ................................................
Sri Gowthami Degree College, Darsi ............................................
Dr. Narayana Degree College of Hotel Management & CT, Sec'bad...
Shalivahana Degree College, Suryapet .........................................
Jagruti Degree & PG College, Hyderabad .......................................
Satavahana College, Vijayawada ..................................................
Siddhartha Degree College, Pydiparru, Tanuku ................................
Girvani Degree College, Chittoor ..................................................
Triveni Mahila Degree College, Vijayawada ....................................
Sir Newton's Degree College for Women, Malakpet, Hyderabad .......
AVR & VPR Degree College, Mandapeta .......................................
Siddhartha Degree College, Narsampet, Warangal.......................
Siddhartha Degree College, wyra, Khammam.......................
Sri Sai Vignan Bharathi Degree College for Women, Secunderabad .........................
Abhyudaya Degree College, Komavarapu Kota .................................
R.G.R Siddhanti College, Secunderabad ...................................

5. Name of the Candidate should be in 'CAPITAL LETTERS' only.


Leave one blank space after each initial or word in the name.
For example : For VELISETTY CHANDRASEKHARA RAO
Name
V E L I S E T T Y
of the
Candidate C H A N D R A S E K H A R A

Father's
Name

SIMILAR PROCESS FOR ITEM NO


for example if date
of birth is SSC 13-04-1975
Day
Month

10 AND 11 ALSO

Notary

8. Date of Birth as per SSC

01=SC
05=ST
Year

7 5

06=BC-A
07=BC-B
08=BC-C
09=BC-D

Code

6. Sex

7 .Marital Status

M = Male
F = Female

M = Married
U = Un-Married

For Example,
M
if Male

For Example,
if Un-Married

086
087
088
090
092
098
103
109
110
113
114
115
118
125
126
127
128
129
130
131
132
134
140
141
143
144
145
146
147
149
150
151
153
154
155
156
157
165
166
168
173
174

9. Reservation Category Code


For Example, if SC
10=PH-VH (Visually Handicapped)
11=PH-HI (Hearing Impaired)
0 1
12=PH-OH (Orthopaedically Handicapped)
13=OC

Enclose : Two Window Covers with Stamps worth of Rs.10/- each.

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