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FORM OF APPLICATION FOR ADMISSION
Name of Applicant
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(in BLOCK LETTERS as per Academic Records)
Name of Parent/ Spouse/ Guardian
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Address Line1
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Address Line2
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City
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State
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Country
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India
Others
Pincode
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Mobile No
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(Add your contact number for future reference)
Phone No
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Email ID
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Gender
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Male
Female
Date of Birth
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DD
01
02
03
04
05
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MM
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10
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12
YYYY
1965
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2003
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2006
2007
Place of Birth
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Select
Rural
Urban
Name of Course applied
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Select
MBA - Marketing
MBA - Finance
MBA - International Business
MBA - Human Resource Management
MBA - General
B.Com
B.B.A
M.Com (Finance)
MA (ENGLISH)
MA (SOCIOLOGY)
MA (HINDI)
Course Code
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PCP Centre Chosen
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Select
Puducherry
Chennai
New Delhi
Madurai
Bangalore
Kochi
Hyderabad
Bhubaneswar
Lucknow
Guwahati
Jammu
Port Blair
Trivandrum
Coimbatore
Vishakhapatnam
Mumbai
Vadodara
Indore
Chandigarh
Guntur
Mahe
Karaikal
Tirupathi
Yanam
Jaipur
Kolkatta
Sikkim
Vijayawada
Centre Code
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Social Status
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Select
SC - 01
ST - 02
OBC - 03
OC - 04
Fee Concession Category
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Select
None - 00
Non-Teaching employees of PU and their wards (Group B C & D) - 01
Defence Personnel in Armed and Paramilitary forces - 02
Physically Challenged - 03
Widows - 04
Deserted Women - 05
Prisoners - 06
Trans-genders - 07
Upload Photo
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Upload Signature
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(Note: Signature size should be below 15KB & in jpg format. Dimension : 140 X 60)
Details of Educational Qualifications
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Examination Passed
Specialization
Board / University
Institution/College
Year of Passing
Class/Grade Percentage
Certificate Attachment
SSLC / 10
th
Std
HSc / 12
th
Std / Equivalent
Degree / Equivalent
Others (Specify)
(Note: Educational attachment should be below 40KB & in jpg format.)
(* - Required fields)