application-form
application-form
2470169081S
Programme Details
Programme Type BACHELOR Programme BAM: Bachelor of Arts Mode Of Study ODL
Regional Center KARNAL Study Center Code GOVERNMENT P.G. COLLEGE (1009) State Code HARYANA
Medium HINDI IGNOU Student ? No
Fee Details
Description Amount(₹)
Development Fee 200.00
Registration Fee 300.00
Total amount 500.00
Payment Details
Transaction Amount : Date : 2024-06-25
Transaction Number : 20233377553 Order Number :
500 17:08:07
Personal Details
Father Name : ISHWAR
Full Name : AJAY KUMAR Gender : A1: Male
SINGH
Nationality : A1: India DOB : 2000-11-11
Area : B2: Rural Marital Status : A1: Single Religion : A1: Hindu
Email [1] : rootuser782@gmail.com Mobile Number [1] : 9992501320
Email [2] : deeps070@proton.me Mobile Number [2] : 7404509200
Correspondence Address : DC COLONY, NEAR RAILWAY Employement Status : A1:
STATION , PH 9992501320, UKLANA MANDI, HISAR, , 125113 Unemployed
Social Status : C3: Not
CATEGORY DETAILS OF B2: SC Minority : B2: No
Applicable
THE APPLICANT
PwD Applicable : B2: No
Scholarship Amount: Scholarship Department: ----- Family Income: Below Poverty Line: -----
Qualification Details
Qualification 10+2 OR EQUIVALENT Main Subjects HINDI, ENGLISH, ARTS,
Year of Passing 2020 Division First
1001 : HBSE : HARYANA BOARD OF SCHOOL
Percent of Marks (rounded off) 75 Board Code
EDUCATION
Board Roll Number 3020200276 NAD Details ,
Upload Details
PHOTO Uploaded
SIGNATURE Uploaded
MATRICULATION MARKSHEET OR CERTIFICATE Uploaded
10+2 MARKSHEET / CERTIFICATE Uploaded
CATEGORY CERTIFICATE (SC) Uploaded
OTHERS1 Uploaded
OTHERS2 Uploaded
Income Certificate for income less then Rs 2.5 lakh per annum Uploaded
Self Declaration
I hereby declare that I have read and understood the conditions of eligibility for the programme for which I seek
admission. To the best of my knowledge and belief, I fulfill the minimum eligibility criteria and I have provided necessary
information and relevant documents with this application. I further undertake that I have not concealed or distorted any
other information and in the event of any information or uploaded documents being found to be incorrect, false or
misleading, my candidature shall be liable for cancellation by the University at any time and I shall have no claim of any
nature including refund of any fee paid by me and all the benefits availed by me shall be summarily withdrawn. I do
undertake that I have carefully studied the rules of the University as given in the prospectus and I accept them in totality
and shall not raise any dispute over the same. I do understand that the university can amend or change any rules without
advance intimation and I will be abiding by them.
I further declare that in the event of admission being granted to me and my obtaining a degree/diploma/certificate from
IGNOU based on concealment of any relevant information or incorrect/misleading information related to Age, Qualification
and Eligibility provided by me, I shall be solely responsible for the consequence(s) arising out of such concealment of
information or providing incorrect/misleading information; and that, the University shall not be responsible in any manner.
AJAY KUMAR
2470169081S