Photo to be attested
by the Head of the
concerned Institution
APPLICATION RECEIVED AFTER THE LAST DATE WILL BE SUMMERILY REJECTED
Every column to be carefully filled in by the candidate
Amount Remitted RsDate of Remittance...........
Cash/M.. Recei!t "o..#hether Recei!t is attached
COCHIN UNIVERSITY OF SCIENCE AND TECHNOLOGY
A!!lication for Re$istration for the ...De$ree.%emester/&ear E'amination in ....())
*. Centre and Place of E'amination
(. "ame of Candidate in En$lish +In ,loc- .etters/
0. A$e 1 Date of ,irth
2. Place of ,irth 3ith District and 4alu-
5.
"ame6 ccu!ation and Annual Income of 7ather or
8uardian
9. Community 3ith %ubdivision6 if any and Reli$ion
:. Permanent Address
;. Address of Communication
<. %ub=ects %elected +%!ecify the elective se!arately/
*). Details of >ualifyin$ E'amination Passed
"ame of E'amination
Percenta$e of Mar-s
"ame of ?niversity
**.
%tate 3hether the @ualifyin$ De$ree Certificate +ri$inal/
3ith a Photoco!y is attached.
*(.
#hether the @ualifyin$ e'amination has been $ot
reco$niAed by this ?niversity in the case of those
?niversities outside Berala %tate.
*0.
4he year in 3hich and the De!t. throu$h 3hich he/she 3as
re$istered as a matriculate of this ?niversity.
*2.
Re$ister "o. Month and year of Passin$ the !rimary
E'aminations +If this not a!!licable6 3rite ".A./. 8ive
details of !a!ers !assed
7irst %emester
%econd %emester
4hird %emester
C
7ourth %emester
7ifth %emester
Affi' a recent
stam! siAe
!hoto$ra!h
*5.
*/ Re$ister "o.6 Month and year of !revious
a!!earance if any6 for the e'amination no3 a!!lied for
(/ 4itle of su!!lementary !a!ers no3 a!!lied for
D E C L A R A T I ON
I hereby declare that the entries made above are correct to the best of my -no3led$e and that
they have been made in my o3n hand3ritin$.
%tationD
Date D SIGNATURE OF CANDIDATE
C E R T I F I C A T E
I hereby certify that the entries made by the candidate have been verified by me6 and I have
found them to a$ree 3ith those in the records of this De!artment.
DateD %eal %i$nature of the Head of the De!artment
CERIFICATE (FOR SC/ST STUDENTS AND THOSE ENJOYING CONCESSION
UNDER K.P.C.R.)
*. 4his is to certify that %ri/%mt. belon$s to
%cheduled Caste/%cheduled 4ribe/ther ,ac-3ard Community +$ive the name of the
caste/tribe/community/ and that he/she is a!!earin$ for the
e'amination for the 7irst/%econd consecutive chance. +%tri-e off 3hich ever is not a!!licable/.
His/Her e'amination fees 3ill be claimed by me from the District #elfare fficer
concerned/Director of Hari=an #elfare6 and the recei!t of the same sent to the Re$istrar.
FOR STUDENTS WHO HAVE BEEN GRANTED FEE CONCESSION UNDER K.P.C.R.
(. Certified that %ri/%mt. has been $ranted fee
concession under B.P.C.R. and that he/she is a!!earin$ for this e'amination for the first time.
%i$nature of the Head of the De!artment/Institution/%chool
Photo to be attested
by 4he Head of the
concerned Institution
COCHIN UNIVERSITY OF SCIENCE AND TECHNOLOGY
+All entries e'ce!t Re$ister "umber to be made by the candidate/
HALL TICKET
Re$ister "o.
De$ree/Di!loma. %emester/&ear/E'amination in ())
,ranch
Centre of E'amD De!t./%chool of
"ame of candidate +,loc- letters/
Code 1 %ub=ect
%i$nature of the candidate
ffice of the Cochin ?niversity of
%cience 1 4echnolo$y6
Bochi E 9;( )((.
DateD
ffice %eal CONTROLLER OF EXAMINATIONS
Affi' a recent
stam! siAe
!hoto$ra!h
INSTRUCTIONS TO CANDIDATES DURING THE UNIVERSITY EXAMINATION
*. Candidates !resentin$ themselves after half an hour of the scheduled time of e'amination as
!er the time table 3ill not be admitted to the e'amination hall.
(. Candidates 3ho are sufferin$ from infectious disease of any -ind 3ill not be admitted.
0. Candidates re$isterin$ for the Re$ular/%u!!lementary e'aminations are directed to affi' a
stam! siAe !hoto$ra!h +not older than si' months/ at the front ri$ht to! corner of the
A!!lication and Hall 4ic-et !ortion and to be $ot attested by the HD under the ffice seal of
the De!artment 3here the candidate is a!!earin$ from. A!!lication 3ithout affi'in$ the
!hoto$ra!h on a!!lication and Hall 4ic-et !art 3ill be summarily re=ected.
2. Candidates should brin$ 3ith them to the e'amination hall on each day of the e'amination6
their Hall 4ic-ets for ins!ection by the Chief %u!erintendent/Assistant %u!erintendent or any
other authoriAed official.
5. Candidates should 3rite their Re$ister "umbers very distinctly in the s!ace !rovided for the
!ur!ose on the outer cover of the ans3er boo-. 4hey are restricted from 3ritin$ their Re$ister
"umbers or any other mar- for identification on any other !a$e of their ans3er boo-. Fiolation
of this may involve the re=ection of ans3er !a!ers.
9. Any candidate detected to mal!ractice or misconduct in the e'amination hall 3ill not be
!ermitted to sit for the remainin$ !a!ers of the e'amination. Fiolation of this instruction may
attract !unishment u!to cancellation of the e'amination ta-en by a candidate or debarrin$ from
3ritin$ e'amination for a !eriod to be decided by the ?niversity.
:. Candidates for e'aminations in %cience sub=ects are re@uired to submit their laboratory
note boo-s to the e'aminers concerned on the first day of the !ractical e'amination and to $et
them bac- at the close of the e'amination.
CONTROLLER OF EXAMINATIONS
