Page No. 1

Sr.No.

 							    Signature of Receipt Clerk _______________________      

KURUKSHETRA UNIVERSITY, KURUKSHETRA 
(Established by the State Legislature Act XII of 1956)
("A" Grade, NAAC Accredited)

EXAMINATION FORM (Private /Ex-Student) Annual/Supplementary/Semester Examinations (Four Pages)

UNDER-GRADUATE CLASSES   

Important Note : Incomplete admission form will be rejected.                                                                                                     Roll No. (to be allotted by the office)

Compulsory to write fee detail in column Concerned :-	
Bank Draft No. Only	For Accounts Branch Only	PNB ‘M.No. only’	OBC K.U.K	

Amount Rs .………………..
Bank Draft No………………
Dated ……………………….	
Amount Rs.. ………………..
Receipt No. …………………
Dated ………………………..	
Amount Rs.. ………………..
Receipt No. …………………
Dated ………………………..	
Amount Rs.. ………………..
O.B.C. Scroll No……………. 
Dated ………………………..	
	
Form Deposit No……………….……Date …………………………..	(To be assigned by the Office)
1.  Examination for which appearing (Class) ………………ANNUAL          SEMESTER SYSTEM
     (Write the name of class in which you have to appear otherwise your exam form will be rejected)
     Session: April/May/Oct./Dec./20….....

      (i)   Full papers      Improvement       Addl.Paper         Compartment       Re-appear   
      (ii)  Category: Regular/Private /Correspondence………………………………

Attested
Photo be pasted
here

Signature of Candidate

Signature of Candidate

2.  K.U.K. Registration No.…………………………………. ......................................

3.   Name in English  
      (Capital Letters)								          

      Name in Hindi 						                                  

4.   Father’s Name
       In English								  		       

        (Capital Letters)
      Name in Hindi

5.   Mother’s Name 
      (In English) (Capital Letters)	
	[[[[[[[[[[				                                                                 
6.   Male/Female……………….............…… Rural/Urban……………….....................	       
7.   Category to which you belong (General/SC/ST/BC/P.H.) ………………..............
8.   Capacity for appearing........................................................
        (Women/SC/ST/Permanent Physically Handicapped/Military Persons/Ex Defence Service Persons belong to Haryana State)
9.   State to which you belong ………………………………………………….............
10. Choice of Centre (i) ……………………… (ii) …………………….. (See list of centers in Instruction enclosed with form)
11. Particulars of Previous Examination(s) on the basis of which applying for the present Examination and proof be attached. The 
       Re-appear/Compartment student must fill up the columns for each availed chance Session wise.
Name of Class	Year	Session	Roll No.	Result (Marks Obtained)	University/
Board	Subjects	
							
12.  Subject offered:-
‘In addition of English and Hindi/Punjabi/Sanskrit compulsory subjects, private candidates(s) shall offer two elective subjects in   
 B.A. Examination from Group-I to V selecting any one subject from a given Group:-
Group – I 	Group – II	Group – III 	Group – IV 	Group – V 	
Defence Studies(for Defence Person only), Hindi, Sanskrit, Urdu, Punjabi, Geography	Mathematics, Pub. Admn., Sociology, Music (Vocal), Music (Instrumental), Music (Tabla), Dance, Health & Physical Education	Political Science, Statistics	Home Science, Philosophy, 
Economics	Psychology, History, A.I.H. Culture & Archaeology	
Note: Language offered as Compulsory subject shall not be offered as Elective subject.

12-A  (1) ………………..….............................(2) ........……........................................... (3) …………………………………….
            (4) ………………..…...........................  (5) ……………….............…………….. (6)…………………………………......
Note: (AFTER FILLING THE FORM IN HIS/HER OWN HANDWRITING THE CANDIDATE MUST RETAIN PHOTOCOPY FOR OWN RECORD)

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13.   Correspondence Address:

Phone/Mobile

PIN

	
14 	Indicate if blind or deaf or permanently 
		disabled from writing with his /her hands 		.................................................................... 
	
15.	Whether appearing simultaneously in lower examination: Yes/No 		. ................
	Name of Exam 		Subject 		.................. 
	University/Board 	. 

16.	If the applicant was ever disqualified or any enquiry is pending against him/her in an Unfair Means Case, 
this fact should clearly be stated with full particulars: 
	Name of the Examination………………..………………..............Year/Session………………..……...…...... 
		RolI No 	University/Board 	Period of disqualification 	..................... 

	17.	For Improvement Candidates only :                       Class         Session                       Roll No.           	Result 
	(i)	Session & Roll No. for passing		_____	      _______		_______	______
		final Examination	
(ii)	Chances availed 			_____	      _______		_______	______

18. 	Please write one sentence in Hindi/English each for specimen 
	In Hindi……………..……………..……………..……………..……………..……………..…….............
	In English ……………..……………..……………..……………..……………..………………...............

Declaration: 
	I solemnly declare and affirm that the particulars given above are correct and true to the best of my knowledge and nothing has been concealed therein. I am eligible for the Examination as per rules and regulations of the University. I have consulted Syllabus, Scheme, Eligibility conditions and have gone through general rules/ instructions of Kurukshetra University, Kurukshetra, before filling it and I undertake to abide by the same in all respects.

Dated……………..						                    SIGNATURE OF THE CANDIDATE

ATTESTATION
(i)	Certified that I have passed the Examination of __________________under Roll No._____________in Annual / Supplementary Examination which is a qualifying lower ?Examination for appearing in the examination of __________to be held in Annual/Supplementary Examination.
(ii)	I am eligible to appear in the examination of _______________________in the capacity of Ex-student/woman/ SC/ST/Handicapped/Defense Personal of Haryana with date of joining. (Tick, whichever is applicable).
(iii)	Certified that I was a regular student of ___________________College/Directorate of Distance Education, KUK during the session ________________to_________________.
Dated:______________	  					        FULL SIGNATURE OF THE CANDIDATE

___________________________bears a good moral character and has signed this form in my presence. Particulars of the Candidate and his/her photo are correct.

Dated:______________						     SIGNATURE OF ATTESTING AUTHORITY
									                 With office seal             	      
For Office use only

Not Eligible due to.....................................	    Clerk		Assistant	Superintendent		AR/DR		
NOTE : Candidate is required to attach two self addressed envelopes of size 9x4 inches with Exam. Form

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FOR CENTRE SUPERINTENDENT
Kurukshetra University, Kurukshetra
(Established by the State Legislature Act XII of 1956)
("A" Grade, NAAC Accredited)

Roll No.-cum-Admit Card
Under-Graduate Examination
To be filled in by the Candidate
Class:_____________________
Annual or
Semester System ____________

April /May/Oct/Dec._________

Roll No. _______________________________
(Assigned  by the office)

Regn. No.______________________________
Name_________________________________
Father’s Name : Sh.______________________
Centre of Exam._________________________
Signature of Candidate___________________
Controller of Exams.

FOR STUDENT
Kurukshetra University, Kurukshetra
(Established by the State Legislature Act XII of 1956)
("A" Grade, NAAC Accredited)

Roll No.-cum-Admit Card
Under-Graduate Examination
To be filled in by the Candidate 
Class:__________________
Annual or
Semester System_____________

April /May/Oct/Dec.___________

Roll No. _______________________________
(Assigned  by the office)

Regn. No.______________________________
Name_________________________________
Father’s Name : Sh.______________________
Centre of Exam._________________________
Signature of Candidate___________________
Controller of Exams.

This slip is to be preserved by the candidate and show on demand on any day of the examination.

Ticket Size attested Photograph

Ticket Size attested Photograph

Important: Mobile Phone/Pager etc. in the 		    Important:   Mobile Phone/Pager etc. in the 
                    Examination Centre is strictly.                                         Examination Centre is strictly 
	        Prohibited.						  prohibited.

                   											             Page No. 5
 Serial No.______   
KURUKSHETRA UNIVERSITY, KURUKSHETRA 
(Established by the State Legislature Act XII of 1956)
("A" Grade, NAAC Accredited)

(This form duly filled in by the candidate in his/her own handwriting must be attached with the examination form)
INCOMPLETE ADMISSION FORM WILL BE REJECTED	
					       		                       Roll No. (to be allotted by the office)
                                                  Computer Form

1.  Examination for which appearing (Class) ………………Annual or Semester System……………….
     Session: April/May/Oct./Dec./20….....

      (i)   Full papers/ Improvement/Addl.Paper / Compartment/Re-appear ………….........................
      (ii)  Category: Regular/Private /Correspondence………………………………

Unattested
Photo be pasted
here

Signature of Candidate

Signature of Candidate

2.   K.U.K. Registration No.…………………………………. ......................................

3.   Name in English  
      (Capital Letters)								          

      Name in Hindi 						                                  

4.   Father’s Name
       In English								  		       

        (Capital Letters)
      Name in Hindi

5.   Mother’s Name 
      (In English) (Capital Letters)	
					                                                                
6.   Male/Female……………….............…… Rural/Urban……………….....................	       
7.   Category to which you belong (General/SC/ST/BC/P.H.) ………………................
8.   State to which you belong ………………………………………………….............
9.   Choice of Centre (i) ………………………..............   (ii) ………………………….
10. Particulars of Previous Examination(s) passed
Name of Class	Year	Session	Roll No.	Result (Marks Obtained)	University/
Board	Subjects	
							
11.  Subject offered (alongwith Subject Code of Papers)
       (1) ………………..….............................(2) ........……........................................... (3) …………………………………….
        (4) ………………..…..............................(5) ……………….............…………….. (6)…………………………………......
12.   Correspondence Address:

Phone/Mobile

PIN

13.  Fee Detail: B.D./OBC/PNB Scroll/Univ. Receipt No. ………........… Dated.…..…..........  `.………......

         Declaration:
         I  solemnly  declare  and affirm that the particulars given above are correct and true to the best of my knowledge and nothing 
         has been concealed therein.

        Date:………………..							                 Signature of the Applicant	

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		      DIRECTIONS AND GUIDANCE FOR PRIVATE CANDIDATES
Important instructions, (Read carefully before filling the examination form)

I.		LAST DATE FOR RECEIPT OF EXAMINATION ADMISSION FORM AND FEE IN THE UNIVERSITY OFFICE EXCEPT MEDICAL & ENGINEERING COURSES W.E.F October 2013

Session	Examinations	Without Late Fee	With Late fee of     ` 500	With Late fee of  ` 1000	
Annual	UG (Regular & CC)	December, 11	December, 20	December, 31	
Annual	UG (Private & Ex-Student)	November, 21	December, 10	December, 20	
Supplementary	UG (Pvt., Ex-Student & Regular)	August, 16	August, 25	September, 10	
Annual	PG (Regular, Private/ Ex-student & CC)	December, 11	December, 31	January, 15	
Supplementary	PG (Pvt, Regular & Ex- Student)	September, 30	October, 10	October, 20	
SEMESTER SYSTEM					
Odd Semester	UG, PG (Regular, Ex-student & Pvt.)	September, 15	September, 30	October, 15	
Even Semester	UG, PG (Regular, Ex-student & Pvt)	February, 15	February, 28	March, 10	
Note : No admission form will be accepted after the last date with late fee of  ` 1000/-	

IMPORTANT INSTRUCTIONS :
Note:   * (i)  Continuation fee ` 100/- will be charged only once during one academic year.
  (ii)  A fine of ` 500/- (Rupees five hundred only) shall be charged from the candidates who are  
        Defaulter of actual examination fee by less than 20%. If the fee due is more than 20% a fine 
        of ` 1000/- (One thousand only) shall be charged.
 (iii)  The Exam. Form will be accepted without late fee within 25 days of publication of result or 
        15 days from the date of dispatch of DMC which is later.

III.	PROVISIONAL LIST OF CENTRES FOR U.G.  ANNUAL + SUPPLEMENTARY EXAMINATIONS 
	For PG Exam. (Annual & Supplementary) : Ambala Cantt., Ambala City, Kaithal, Hisar, Jind, Sirsa, Kurukshetra, Shahabad (M), Karnal, Panipat & Yamuna Nagar. The centres are provisional.

	For UG Exam. (Annual Examinations): Ambala Cantt, Ambala City, Barara (Only for Girls), Mulana,  Naneola, Naraingarh, Panchkula, Barwala, Kalka, Kaithal, Cheeka, Kaul, Pundri, Dhand-Dadwana, Karnal, Assandh, Matakmajri (Indri), Gharaunda, Panipat, Samalkha, Madlauda, Israna, Kurukshetra, Ladwa, Pehowa, Shahabad Markanda, Loharmajra, Ismailabad, Yamuna Nagar, Jagadhari, Radaur, Sadhaura, Jind, Narwana, Safidon, Hisar, Mandi Adampur, Hansi, Fatehabad, Tohana, Ratia, Bhattukalan, Sirsa, Mandi Dabwali, Jiwan Nagar, Ellenabad, Odhan (for Girls Only). 
	For Supplementary Examinations: Ambala Cantt, Ambala City, Kaithal, Kalka, Karnal, Kurukshetra, Panipat, Yamuna Nagar, Jind, Hisar, Fatehabad, Hansi, Sirsa. 

University reserves the right to create or abolish any centre(s) at any stage.

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IV.	The candidates desirous of appearing privately under the ordinance for private candidate of Kurukshetra University, Kurukshetra in various Under-Graduate/Post Graduate examinations will submit their examination forms complet in all respects. They will deposit the required examination fee at any of the C.B.S. authorised branch of Punjab national Bank and will attach original receipt thereof with the examination form. The compartmental/re-appear candidates who are regular students of higher classes shall submit their examination forms through the college/Department concerned. 

IMPORTANT NOTES :
Only (1.) member of Scheduled Caste/Tribe, (2.) A Woman Candidate, (3.) A permanently Physically Handicapped, (4.) Serving Military Personnel. All belonging to state of Haryana are eligible to appear as private candidates as fresh.
1.	The student should read very carefully the following note before depositing the Fees. Students who are appearing as a fresh and enrolled 1st time in this University will pay the fees given in the prescribed column for fresh candidates.
2.	This fee include migration fees of  ` 100/- which will be charged from students who have not passed 10+2 examination & other qualifying exam. i.e. B.A./B.Sc./B.Com. from Haryana Education Board, Bhiwani and Kurukshetra University, Kurukshetra respectively.
3.	Fees mentioned for Ex-students include ` 50/- which is payable for Annual Examination only.
4.	Penalty Fee of `1000/- per year be charged with a maximum of `5000/- from the candidate who submits their Migration Certificate after the declaration of the result of the class in which the candidate had appeared.
5.	Ex-students of MBA 5-year, LLB 5-year or other Technical courses for which qualifying Examination is 10+2 have to pay continuation fee @ ` 200/- instead of ` 50/-.
6.	Examination Fees once paid is neither refundable nor creditable to the candidates account for any subsequent examination, even if the admission form is not submitted or the candidate is unable to take the examination.
7.	Candidate seeking admission in an examination on the basis of lower examination passed from other than Kurukshetra University, Kurukshetra should send the original Certificate of the examination. Photocopy is not acceptable. The Original Migration Certificate from other University/Board may also be attached with the admission form.
8.	All candidates (Men & Women) must affix with gum one copy of the Photograph (size 3x2) on page 2 of the admission form and two copies on the Roll No.-cum-Admit Card at the space provided for the purpose, duly attested by the same officer who attested the admission form and one photograph on Computer Form (Unattested).
9.	Application for change of Paper and/OR centre OR any other entry in the form after its submission, will be considered only if received one month before the commencement of Annual Examinations and 15 days in case of Supplementary Examinations alongwith prescribed fee of `100/- for change of subject and ` 250/- for change of centre on prescribed Form available at University Press. Until and unless the candidates get written permission for change in paper/centre he/she shall not be allowed to appear in that paper/centre.
10.	In all correspondence including telegrams with the University Office till the receipt of Roll No.  the candidate must give his/her name and father’s name, name of examination, subjects offered, centre, University Fee Receipt No. and correspondence address. After receipt of Roll No., name of examination and the Roll No. allotted by the Kurukshetra University be quoted without these particulars, not reply may be expected.

11.	LATE FEES WILL BE APPLICABLE FROM THE DATE OF DECLARATION OF RESULT AND DATE OF DESPATCH OF DMC.

SUBMISSION OF MIGRATION CERTIFICATE:
	Last date for submission of Migration Certificate in the University is the last date prescribed for submission of Exam. Form and with late fee for the Examination concerned and after that late fee of  ` 200/- will be charged. Late fee will not be charged if the admission form is received with late fee of  ` 500/- or ` 1000/-. The candidate will not be allowed to appear in the examination if he/she does not submit the Migration Certificate upto 28th February of the year. But in exceptional cases, where the Vice-Chancellor is satisfied, the candidate can appear in the 

Page No. : 9

examination provided that he/she furnishes an affidavit with late fee or ` 400/- duly verified by the first class Magistrate that he/she is not appearing in any other Exam., simultaneously from any University. But if he fails to submit the Migration Run on.
Certificate upto the time of declaration of result his/her candidature will be cancelled. But even if the candidate submits the Migration Certificate within one year from the date of declaration of result with late fee of  ` 1000/- his/her result can be revived.
Use of Ink : Candidate must use only Blue or Blue Black Ink.

12.	(i)	Candidates are allowed to appear according to old syllabus only in compartment cases, in 1st supplementary examination. The candidates of all other categories likewise additional/ Deficient/Full Subjects/Improvement will have to appear according to the new syllabus in force for the regular students unless otherwise stated.

	(ii)	Candidates who do not mention the Centre of Examination will be allowed Centre as per his/her address and he/she will not claim for change of it, without fee of ` 250/- if otherwise eligible as per rules.
13.	In case of candidate submits the migration certificate before appearing in the Annual Examination is not required to submit the affidavit. If any candidate passes due to re-evaluation before the date of Examination, he/she is not allowed to appear in the Exams. even if he/she receives the Roll No.
14.	In case a private candidate having Practical subjects – Geography, Psychology/Home Science, he/she should submit practical attendance certificate from the Principal of recognized colleges.
15.	In case a candidate does not receive his/her Roll No., 10 days prior to the commencement of the Examination he/she should contact the Deputy Registrar/Assistant Registrar (Exams.) for this purpose.
16.	FOR IMPROVEMENT OF MARKS
	The Candidate who have passed B.A./B.Sc/B.Com etc. (General) Examination from this University and is desirous of improving the Result/Performance shall be allowed within a period of two years after passing of final examination to appear in one or more Theory Paper(s) of the B.A./B.Sc. /B.Com etc.(General) one or two parts of I, II, III separately Annual Examination(s) which will be held in the month of April. Such candidate shall appear according to latest syllabi. The result for such candidates shall be declared only if they improve the result/performance. D.M.C. will be sent by UPC/Regd. Post.
17.	FOR ADDITIONAL SUBJECT(S)
A candidate who has passed the B.A./ B.Sc.(Hons.) /B.Sc   (General) /B.Com./ BCA/ BIM/ BTM/ BBA/ BHM&CT Examination from this University or the M/A./M.Sc/M.Com. Examination from this University or from any other recognized University in India, may appear in any one or more additional subjects prescribed for the B.A./B.Sc. examination subsequently except the subjects in which he/se has already passed the examination.
18.	PROPER AUTHORITIES FOR ATTESTING THE APPLICATION FORM ARE AS UNDER :
(i)	Ex-students	By the Principal of the College last attended/ Directorate of Distance Education in case of D.E. of K.U.K.(or by Gazetted Officer in case of D.D.E. only)
(ii)	Students of unrecognized college for	By the Principal of the College concerned.
	women permitted to send up their		
	Admn. Forms as private Candidates.
(iii)	Military Personnel	By Commanding Officer of the Unit.

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(iv)	Women and all other	By Head of the College/University Teaching 
Categories	Departments/Principal of the colleges in the State 
	of Haryana or by such persons as may be 
	authorized by the Academic Council for the 
	purpose. Principal of Govt. Sr. Sec. School.
19.	REGARDING SCHEME OF EXAMINATION AND OTHER RELEVANT RULES TO THE COURSE, PLEASE CONSULT THE UNIVERSITY CALENDAR VOLUME-II, 2003 OF KURUKSHETRA UNIVERSITY, KURUKSHETRA. THE DETAILED SYLLABI OF THE COURSE CAN BE OBTAINED FROM THE MANAGER, PRINTING AND PUBLICATIONS, UNIVERSITY PRESS, KURUKSHETRA UNIVERSITY, KURUKSHETRA ON PAYMENT OF REQUISITE CHARGES.
THE STUDENTS ARE REQUIRED TO SEND THE ADMISSION FORM TO THE CONCERNED BRANCHES AS UNDER:
Dy./Asstt. Registrar (Exams-I)
B.A.-II, B.Com.-II, III, B.Sc.-II, BIM-II & III
B.Sc.-Home Science
B.C.A.
Dy./Asstt. Registrar (Exams-II)
B.Ed., B.A.-I., B.Sc.-I/Visharad/Gyani/Rattan/Prabhakar/Shastri
Dy./Asstt. Registrar (Exams-III)
B.A.-III, B.Sc.-III, B.B.A., C.C.A. & C.P.Ed./Prajna/Budhimani
B.Com-I, BIM-I, B.Sc. I.T. (I,II,III)

KURUKSHETRA UNIVERSITY, KURUKSHETRA

No examination form will ordinarily be entertained after the date with late fee of ` 500/- and in abnormal circumstances it will be accepted with late fee of ` 900/-, if appearing simultaneously in lower examination, submit form and fee for each separately.

20.	Mode of Payment:

	Fee to be paid in any CBS Branch of PNB in India or Oriental Bank of Commerce, K.U.K. Branch or through Bank Draft, preferably drawn on State Bank of India or IPOs in favour of Registrar, Kurukshetra University, Kurukshetra.

	The Candidate should keep the postal receipt and the Acknowledgement, University Receipt till he/she gets Roll No. from the University.

21.	Tentative Centres for Supplementary Examinations :
	Ambala Cantt., Ambala City, Kaithal, Kalka, Karnal, Kurukshetra, Panipat, Yamuna Nagar, Jind, Hisar, Fatehabad, Sirsa.

	The above list is provisional. The University reserves the right to create or abolish at any stage of the examination centres.

	Examination admission forms can be had from the Manager, Printing & Publications, K.U. Kurukshetra on payment of ` 10/- (Ten in cash)  at the counter and ` 20/-(Twenty) by the post and ` 45/- (Forty Five) if required by Regd. Post or Can be downloaded by the Internet.

22.	Private candidates of B.A./B.Sc./B.Com. etc. registered for the Academic Session 2004-05 will have to offer the subject of Environmental Studies in the IInd  or IIIrd year of Bachelor Degree Course during the Academic Session 2005-06 and 2006-07 respectively, if otherwise eligible.