Mata Sundri College For Women

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PARTICULARS TO BE FILLED IN BY THE CANDIDATE Exam. Fee Rs. ……………... Marks Fee Rs………………. Late fee if any Rs. …………. Total Rs. …………………… Sign Dealing Name of College Previous Exam. Roll No. Examination Roll No. Asstt……………………… (To be allotted by the College) MEDIUM : 1. SEMESTER (Tick (v) as applicable) English Hindi (Note: - Students should be advised to see the date sheet which is available on DU website, www.du.ac.in) 2.(a) Name of the candidate (In Block Letters as written on the Enrolment Form) (b) Address & Phone No.: Please affix your recent Photograph duly attested by the Principal of the College 3. (a) Father’s Name Full Signature of Candidate (b) Mother’s Name 4. Gender Male Female 5. Date of Birth 6. Category: Schedule Caste/Schedule Tribe/ Visually/ Physically Handicap/other Backward Class 7. University Enroll. No. (Mandatory)_________ 8. Year of admission to the Course___________ 9. Papers in which the candidate is to appear:- Practical paper, (if any) should be specified separately. SEMESTER-II SEMESTER-IV SEMESTER-VI PAPER CODE PAPER DESCRIPTION PAPER CODE PAPER DESCRIPTION PAPER CODE PAPER DESCRIPTION Examination Year (s) Roll No. Result I Semester II Semester III Semester IV Semester V Semester VI Semester 11. Have you applied for Revaluation/Rechecking? If yes, give details 12. Whether exempted from Compulsory Test in Hindi Yes/No If yes, give details of the Examination passed with Hindi UNDERTAKING (For improvement cases only) I hereby forego the result in the following paper/s of II/IV/VI Semester Examination taken by me in May-June 2018 under Roll No. And will be reappearing in the said Paper(s) at the examinations to be held May-June 2018. . SEMESTER-II SEMESTER-IV SEMESTER-VI PAPER CODE PAPER DESCRIPTION PAPER CODE PAPER DESCRIPTION PAPER CODE PAPER DESCRIPTION The above information is true and correct and if found incorrect or concealed, I am liable to be declared disqualified and also to face cancellation of the examination taken by me. I fully understand that my result in the above-said Paper/s will be determined on the basis of my current performance at the said examination. ….............................................. Dated 2018 Signature of the candidate CERTIFICATE ((FOR REGULAR STUDENTS ONLY) I CERTIFY (a) That the details furnished by the student in his/her application have been checked and found to be correct and that the candidate is eligible for admission as an Ex-student. (b) That the candidate bears a good moral Character. (c) That the candidate was not detained due to Short of attendance in the said Examination Examination Fee: ………………………………………………. Signature of the Principal/Head (With Seal) Rs. 100/- per paper with minimum of Rs. 400/- for each part/semester of the examination. Fee for supply of Statement of Marks is Rs. 100/- Examination forms fee is Rs. 10/- each. Additional Fee for each Practical Paper is Rs. 200/- (Wherever applicable). Additional Fee of Rs. 500/- along with the Exam. Fees (as applicable to ex-students).