Vinayaka Mission University

   NH-47 Ariyanoor Salem Tamil Nadu

    Recognized by U.G.C

   Approved by Distance Education Council, IGNOU, New Delhi

Admn. Appln.  No………………. ………………………………

 
 

 


                                                                                                            

 

 

 

 

                                          APPLICATION FORM FOR ADMISSION

                                                   (With in CAPITAL letters only)

 

Enrollment No. :               

(For Office use only)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Academic year 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Course and Specialty Applied for                

 

 

 

 

 

 

 

 

 

 

 

 

 

Year Applied

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of the Study Centre :  APARK INSTITUTE OF EMPLOYMENT EDUCATION AND RESEARCH GWALIOR                    Center Code:   MP008               

 

1.        Name of the Applicant as in the Birth Certificate of Marks card of Standards X Exam.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.     Father’s Name 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.     Sex :            Male         Female    ---------------     4.   Date of Birth & Age: ------------------------      Date: Month-------------------------------Year------------------------------ Age-----------------------------

                                                                                                                                                                                               

5.     a) Personal Marks of Identification :     --------------------------------------------b)  blood  Group :  ---------------------------------------------------------------------------

 

                   

 

6.     Address for Correspondence   (do not repeat name)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
 


    City                                                       State                                                                           Pin Code: ---------------------------------

 

 

 

 

 

 

 

 
    Country                                           STD Code                                                                           Phone 

 

 

 

 

 
 


  Mobile :                                               E-mail 

 

7.              Permanent Address (do not repeat name)

 

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