KARNATAKA VETERINARY, ANIMAL & FISHERIES SCIENCES UNIVERSITY, BIDAR

APPLICATION FOR ADMISSION TO UNDERGRADUATE DEGREE PROGRAMMES 2012-13

Read the Prospectus before filling the application. Enclose all the required attested copies of Certificates, Marks card & Affidavit along with the application and the Demand Draft (Rs. 300 for SC/ST/Cat-I and Rs.600 for others) and submit your application to the following address only The Registrar, KVAFS University, Nandinagar , Bidar-585 401

Affix attested passport size photograph

PUC College Code No GOK CET Reg.No.

(For BVSc&AH only)

FOR OFFICE USE ONLY Application NO.

DD NO. & Date Bank & Branch Amount Scrutinized by Verified by

1.Full name of the applicant (As entered in PUC or equivalent examination marks card)

2. Indicate the degree for which you are an applicant (write Yes or No) BVSc&AH B.Tech (D.Tech) B.F.Sc

Date Month 3. a) Date of Birth ( Enclose copy of SSLC Marks card for proof)

Year

b) Place of Birth c) Taluka of Birth d) District of Birth e) State of Birth f) Age in years

4. Gender 5. Nationality 6. Religion 7. Mother tongue 8. Caste

9. Indicate the category under which you are claiming the admission (vertical reservation) Enclose appropriate Certificate of category and affidavit (See prospectus) GM SC
ST CAT-I

2A

2B

3A

3B

9.a. If you are claiming a seat under reservation category other than GM mention your caste and sub-caste if any

Caste

Sub Caste

10. Indicate the Special group under which you are claiming the admission (horizontal reservation) and enclose appropriate Certificate (see prospectus) Mark ( ) in the box which ever is applicable RUR KAN NCC SPO S&G DEF EXS PD A-IND

10. a If you are claiming a seat under NCC special category, specify the preference criteria as per the prospectus Preference Mark ( ) 1 2 3 4 5 6 7 8

10. a. If you are claiming a seat under Sports Special Category, specify the details of Medal(Gold/Silver/Bronze) secured

Super A Games

A Games

B Games & participated in super A or A Games

B Games

Mark ( ) in the box which ever is applicable

11. a. Fathers Name _______________________ 12. a. Mothers Name_______________________ 13.a. Guardians Name and Relationship (If both the parents are not alive) 14. a. Permanent Address ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ Dist

b. Major occupation______________________ b. Major occupation ______________________ b. Major occupation ______________________

b. Correspondence Address _______________________________________ _______________________________________ _______________________________________

Pin code _______________________________________ Phone No. & code ______________________________________ Mobile Phone No. ______________________________________

15. a. Are you domicile of Karnataka? (if yes, indicate under which clause you are eligible and enclose relevant documents in support of your claim) Clause A B C D E F G H I J K L M :Marks () in the box which ever is applicable

b. Number of full academic years studied in Karnataka c. Have you studied 1st to 10th standard in rural area? Yes / No If yes, enclose certificate (see prospectus) Note: If your are Gadinaadu or Hornaadu Kannadiga, furnish affidavit (see prospectus)

16. Educational details from 1st Standard up to II year PUC or equivalent examination (enclose relevant certificates) Sl No. 1. Name & address Of the school/college Class(es)/ Standard(s) Studied Primary School Education (1 to 4th Std) Year of study From To Year of passing Study in Rural area* Medium of Instruction**

Secondary School Education (5th to 7th Std)

Higher Secondary School Education (8th to 10th Std)

I & II year PUC or Equivalent Education

* Enclose Certificate in support of your study from 1st to 10th Standard in Rural area for claiming reservation under rural quota (see prospectus) ** Enclose certificate in support of your study from 1st to 10th Standard in Kannada medium for claiming reservation under kannada Medium study ( see prospectus)

17. a) Furnish the information about your overall performance in II year PUC or equivalent examination (enclose copies of the Marks card of II year PUC or equivalent examination )

Total marks prescribed

Total marks secured

Overall percentage

b) Furnish the marks obtained in PCBE subjects in the II year PUC or equivalent examination and marks obtained in PCB in CET (to be filled by the candidates who wish to apply for B.V.Sc.&AH)

Physics (P)

Chemistry (C)

Biology (B)

English (E)

Aggregate in PCBE of II PUC Total Marks Percentage

Aggregate in PCB of CET Total Marks Percentage

c) Furnish the marks obtained in the following subjects in the II year PUC or equivalent examination ( to be filled by the candidates who wish to apply for (B.Tech(D.Tech) & B.F.Sc) Physics (P) Chemistry (C) Mathematics (M) Biology (B) Aggregate in PCMB Total Marks Percentage

18. Tick the preference for place of Counseling for admission

BANGALORE

BIDAR

YES NO 19. Are you claiming seat under Agriculture Quota If yes submit relevant certificates/Affidavit (See page No.32-35 of prospectus)
a) b) c) d) By Actual Cultivation/Agriculture labour/Animal Husbanry/Fisheries ( to be supported by certificate A) Gross salary including all allowances (to be supported by certificate-C From Business (Certificate-B/Affidavit) From other sources (Certificate-B/Affidavit) Total Rs. Rs. Rs. Rs. Rs.

DECLARATION I hereby affirm that the information given by me in this application is complete and true to the best of my knowledge and belief and that I have made this application with the consent and approval of my parents/guardian. In the event of me being admitted to any of the constituent colleges of the University, I undertake to abide by the academic/disciplinary rules and regulations as prescribed from time to time. The University may refer for verification to any authority at any time regarding the correctness about the facts furnished in or along with the application. In case any of the information furnished in this application is proved in correct or false, the admission granted to me in KVAFSU can be cancelled at any time during the tenure of my study in the University. Place : Date:

Signature of Father/Mother/Guardian* (* if both the parents are not alive)

Signature of the Applicant

Karnataka Veterinary, Animal and Fisheries Sciences University, Bidar

APPLICATION FOR UNDERGRADUATE ADMISSION 2012-13

CHECK LIST FOR ENCLOSURES TO APPLICATION FORM

Sl No. 1 2 3 4 Enclosures Demand Draft ( for all) SSLC marks card ( for all ) PUC Marks card (for all) CET Marks ( for all applicants to BVSc& AH ) Yes/No For office use only

Domicile proof
5 6 7 8 Certificate VI Certificate IX (for Hora / Gadinadu Kannadiga) Certificate XIV/XV /XVI (for Defence Personnel) Any other:

Reservations
9 10 11 12 13 14 15 16 17 18 19 20 Certificate II Form D ( for SC/ ST) Certificate III Form E ( for Cat-1) Certificate IV Form F ( for OBC) Certificate V Affidavit: (for SC/ST/Cat-1 & OBC) Certificate VII & VII A: ( for Rural study) Certificate VIII ( for Kannada Medium ) Sports Certificate ( if claimed only) NCC certificate ( if claimed only) Certificate A ( For Agriculturist Quota) Certificate B & C ( For Agriculturist Quota) Any other: