1064146
Application form ____________________ PRICE: Rupees Three Hundreds Only
(For office use only)
(1) Enrolment No. Centre Code. AMUICT
SESSION: 2022-23
Center for Distance and online Education
ALIGARH MUSLIM UNIVERSITY, ALIGARH
Application Form for Admission
(2) Name of the Course Applied For Bachelor of Arts (BA) with Apprenticeship
(3) Aadhar Card No 462426160909
(4) Total Amount Paid Rs.
Photo
DD/Cash Receipt No. Dated Amount (Rs.)
(5a) Tick mark for medium of course for class XI and B.A. HINDI URDU
Compulsory Subjects (for class XI, B.A. or B.COM): Please tick mark in the required blanks.
Compulsory English ✔
(For B.A. or B.Com) Theology (Sunni Shia INM ✔ ) (Adv. Urdu / Ele. Urdu Ele.Hindi ✔
th
(For XI ) Theology (Sunni Shia HMC ) (Adv. Urdu / Ele. Urdu Hindi Ele. NMT
Please Mention the following for B.A.
Political Science
Main Subject ____________________________
History
Subsidiary Subject (i) ________________________ English
(ii) _____________________________
(5b) Please Mention Optional Subjects for Class XI
(i)________________________ (ii) _______________________________ (iii) ________________________________
(6) Name of the candidate (as in High School Certificate in Capital letters)
M O H A M M A D R E H A N
(7) Date of Birth (as in High School Certificate)
24/10/2005
In Figures __________________________ In words _____________________________________
(8) Sex (M/F) ____________
M Indian
(9) Nationality __________________ (10) State/UT of India (Code) Delhi
MD sultan
(11) Father’s Name ______________________________ sakina bagum
(12) Mother’s Name ______________________________
(13) Details of Qualifying Examination
Examination Roll No. Year of Passing/ Board/ Marks Maximum Marks Division Remarks
Appearing University Obtained
senior school certificate examination
14624665 2023 CBSC 500 First division Pass
*Write result awaited (RA) if result is not declared
(14) Details of Examination passed till date:
Examination Roll No. Year of Passing/ Board/ University Marks % Division
Appearing
Note : Kindly read the Prospectus carefully before filling the Admission form.
--------------x-----------------x-----------------x----------------x----------------------x-------------------x----------------------------x---------
1064146
Application form No. _________________________ Name of the candidate MOHAMMAD REHAN
_____________________________________
Bachelor of Arts (BA) with Apprenticeship
Applied for ____________________________
Dealing Assistant
(15) Declaration by the candidate:
MOHAMMAD REHAN
I ____________________________ hereby solemnly declare on oath that the entries made by me in the Admission form columns are
true to the best of my knowledge and behalf and if any time, the entries are found incorrect, the admission may out right be
rejected and disciplinary action may be initiated against me.
PERMANENT/CORRESPONDENCE ADDRESS
_________________________________________________
NO .F 1/187,sanghm vihar
_________________________________________________
New Delhi
_________________________________________________
P.O./City __________________________________
Delhi Thumb impression of the candidate
Male (LTI)/Female (RTI)
District ________________________________
Delhi
Contact No. ______________
9899389109
Signature of Parent/Guardian ___________________
Relationship with Applicant ____________________
Signature of the candidate
Place ________________ Dated: _________________
22/05/2023
22/05/2023
Dated ______________
(16) Information for Statistical Purpose:
Muslim
(a) Community / Religion __________________ Aadhar
Sunni / Shia __________________________________
General
(b) SC/ST/OBC ______________ Urban
(C) Rural/Urban _____________________________
(17) CHECKLIST: All the attached enclosures should arrange serially as per following check List with Application From.
For 1. Self attested copies of High School in Support of DOB.
Office 2. Self attested copies of Marksheet/Gradesheet of Qualifying Examination.
Use 3. Copy of Aadhar Card
4. Caste Certificate copy in case of special Category.
NOTE:Original Certificates/documents not be attached with the application form in any case.
For Office Use
Verified Original Documents.
The Candidate is eligible for admission to________________________________
Remarks_________________________________________________________
_________________________________________________________
Verifying Officer _________________________
Dept. of _________________________
Dated ________________________
Bachelor of Arts (BA) with Apprenticeship
(18) Admitted to ____________________________ Class/Course and allotted Faculty Roll No. ______________________________
Dated: _____________________ DIRECTOR, CDE
Application No. 1064146 Admission Card
(Center for Distance and online Education) Paste Recent
A.M.U.,Aligarh Photograph
1. Enrolment Number Academic Session [2022-23]
[FOR STUDENT]
2. Student’s Name : MOHAMMAD REHAN
3. Father’s Name : MD sultan
4. Mother’s Name : sakina bagum 5. Class / Course : Bachelor of Arts (BA) with Apprenticeship
6. Faculty 7. Male / Female
8. Date of Birth : 24/10/2005 9. Religion : Muslim
10. Place of Birth : sangam vihar(New Delhi) 11. Rural / Urban : Urban
12. Special Category (if Any) 13. State Delhi
14. Examinations Passed senior school certificate examination
15. Nationality : Indian
16. Aadhar Card No. : 462426160909
17. Certificates/Documents verified and their attested 18. Admission No. : 1064146
Copies attached with Admission form
………………………………… ………………………….
Dated…………………. Verifying Officer Dated…………………. Dealing Assistant
19. Fees deposit by Bank Draft(No.) 22. Correspondance/Permanent Address of Student:
NO .F 1/187,sanghm vihar
…………………………………………………………………
1. ……………………………… Amount ………………………………… New Delhi
2……………………………….. Amount …………………………………
…..................................................................
........................………………………………………….
New Delhi
……………………………………………
Tel:........................... Mob:........................
Dated…………………. Dealing Clerk(A/c)
PIN
20. ADMITTED to …………………………………………………………
Class/Course : .……………………………………………………………
……………………………………………………………………………………… Dated ……………………
Dated …………………………………… ………………………………… Signature of Student
DIRECTOR
Application No. 1064146 Admission Card
(Center for Distance and online Education) Paste Recent
A.M.U.,Aligarh Photograph
1. Enrolment Number Academic Session [2022-23]
[FOR C.D.E OFFICE]
2. Student’s Name : MOHAMMAD REHAN
3. Father’s Name : MD sultan
4. Mother’s Name : sakina bagum 5. Class / Course : Bachelor of Arts (BA) with Apprenticeship
6. Faculty 7. Male / Female
8. Date of Birth : 24/10/2005 9. Religion : Muslim
10. Place of Birth : sangam vihar(New Delhi) 11. Rural / Urban : Urban
12. Special Category (if Any) 13. State Delhi
14. Examinations Passed senior school certificate examination
15. Nationality : Indian
16. Aadhar Card No. : 462426160909
17. Certificates/Documents verified and their attested 18. Admission No. : 1064146
Copies attached with Admission form
………………………………… ………………………….
Dated…………………. Verifying Officer Dated…………………. Dealing Assistant
19. Fees deposit by Bank Draft(No.) 22. Correspondance/Permanent Address of Student:
NO .F 1/187,sanghm vihar
…………………………………………………………………
1. ……………………………… Amount …………………………………
2……………………………….. Amount …………………………………
…..................................................................
........................………………………………………….
New Delhi
……………………………………………
Tel:........................... Mob:........................
Dated…………………. Dealing Clerk(A/c)
PIN
20. ADMITTED to …………………………………………………………
Class/Course : .……………………………………………………………
……………………………………………………………………………………… Dated ……………………
Dated …………………………………… …………………………………
DIRECTOR Signature of Student
