BHARATHIAR UNIVERSITY : COIMBATORE 46.

APPLICATION FORM TO APPEAR FOR THE UG/PG/MBA/MCA DEGREE/ALL DIPLOMA

ARREAR EXAMINATION
[FOR THE STUDENTS OF DISTANCE EDUCATION]
December 2014
1. Month & year of Examination : December 2014

2. a) Examination Centre Code :


3. Name of the Candidate [In capital letters) :





4. Date of Birth :




5. Enrolment Number :




6. Examination Register No. (Allotted in the previous appearance):




7. Month and year of last examination appeared:


8. Address for communication with Cell No.:




9. Degree & Branch :

10. Subjects to which the candidate takes up the examination appearing in this
appearance:

Title of subjects (Theory and / or Practical] Subject code












[PTO]


.. 2 ..


Details of Payment & Fee:

1. D.D. No._______________________________

2. Date __________________________________

3. Bank __________________________________

4. Rs._____________________________________

DECLARATION

It is, hereby, declared that the particulars furnished above are true to the best of
my knowledge. I have read the instructions and understood that my candidature will
be cancelled if any of the information furnished is found false.




Station :

Date : Signature of the Candidate


NOTE :- The Controller of Examinations reserves the right to allot any Centre to the
candidate for appearing the Theory and Practical examinations other than the Centre
specified by the candidate in the application, if there is no sufficient number of
candidates in it.