Details of Registration & Admission Test Fee/ Processing Charges Page 1 of 3

Course Name DD/C.R. No. Amount Transaction ID: 8000428/MBAM

with date (Rs.)
(For Office Use Only)
M.B.A. 943312, 600
2010-11-16

Instructions:
___________
1.Please read the supplement for
AMU centre at Malappuram / Murshidabad TO A.M.U. CENTER
AT MALAPPURAM / MURSHIDABAD

(1) Course Applied For M.B.A.

(2) Faculty MANAGEMENT STUDIES & RESEARCH

(3) Status External 4(a) Enrolment No. 4(b) Hall (Code Only)
(Internal/External) (For the candidates enrolled at AMU, Aligarh)

(5) Indicate preferences for Two Admission Test Centres, write 1 & 2
ALIGARH (UTTAR PRADESH) 2 KOLKATA(West Bengal) 1 KOZHIKODE (Kerala)
(6) Tick any one of the study centre
✔ MALAPPURAM (Kerala) MURSHIDABAD (West Bengal)

(7) Name of the Candidate: (Mr./Ms.) MAHESH CV

(As in HS/SS Certificate)
(8) Father's Name KUNHIRAMAN K (9) Mother's Name KARTHYANI CV

(10) Date of Birth Day Month Year (11) Gender(M/F) M (12) Nationality INDIAN
2 0 0 5 1 9 8 8 (13) Special Category Code i) B C ii) N N iii)
(Attach Attested Certificate)
(14) Corresspondence Address (15) Permanent Address
KOTTARATHIL HOUSE,KULAPPURAM KOTTARATHIL HOUSE,KULAPPURAM
PO VILAYANCODE,VIA MANDUR, PO VILAYANCODE,VIA MANDUR,
District KANNUR State K R District KANNUR State K R
Pin 6 7 0 5 0 1 Pin 6 7 0 5 0 1
Tel./Mobile No. 9 4 0 0 5 5 1 2 4 3 Tel./Mobile No. 9 4 0 0 5 5 1 2 4 3
Email maheshvilayancode@gmail.com Email maheshvilayancode@gmail.com
(16) Details of Qualifying Examination (*Write Result Awaited (RA) if result not declared)
Year of Passing/ Board/ Maximum
Examination Roll No. Marks Remarks*
Appearing University Marks
BSC PHYSICS 41721 2009 OUB 731 1000
(17) Whether the candidate ever debarred, disqualified, suspended or rusticated (Yes/No) : No
(Attach photocopies of the office order)
(a) Examination (b) Year
(c) Punishment awarded (d) Period (e) Exam No.

(18) Is Hostel Accommodation Required? (Yes/No) : YES (19) Domicile State K R

(code Only)
(20)Employed (Yes/No) : No (If yes, No Objection Certificate from the present employer must be enclosed.)
(21) Declaration
I, hereby solemnly affirm that I have gone through the relevant pages of Guide to Admission 2010-11.I, MAHESH CV,
hereby solemnly declare on oath that the entries made by me in the above columns are true to the best of my knowledge and
belief and if at any time, the entries are found incorrect, the admission may outrightly be cancelled and disciplinary action
may be initiated against me.

_________________________ _________________________
Date: 2010-11-16 Thumb impression of the candidate, Male(LTI), Female(RTI) Signature of the candidate
 Page 2 of 3

(22) Information for statistical purpose

(a) Religion:________________
HINDUISM (b) Rural/Urban:________________
RURAL
(c) Father's/Guardian's monthly income Rs :________________
3000 (d) Occupation:________________
FARMER

(23) CHECK LIST: Following enclosures are attached with this Application Form
Note: Original certificates/documents not to be attached with the Application Form in any case.
For Office Use 1. Crossed Demand Draft/Cash Receipt For Office Use
2. Self attested copy of HS/SSC in support of date of birth Verified Original Documents
The candidate is eligible for
3. Self attested copies of Marksheets/Grade sheets of qualifying admission to _______________
Examination
4. ________________________________________________ Remarks ______________________
_____________________________
5. ______________________________________________________
Verifying Officer_________________
6. ____________________________________________________
Signature of Dept. of _____________________
Scrutiny Officer Date __________________________

(24) Candidate is required to write in CAPITAL LETTERS his/her name and complete postel address for correspondence.

Name : MAHESH CV | Name : MAHESH CV

Address : KOTTARATHIL HOUSE,KULAPPURAM | Address : KOTTARATHIL HOUSE,KULAPPURAM
PO VILAYANCODE,VIA MANDUR, | PO VILAYANCODE,VIA MANDUR,
District : KANNUR State:KR | District : KANNUR State:KR
Pin Code 6 7 0 5 0 1 | Pin Code 6 7 0 5 0 1
Tel./Mobile No. 9400551243 | Tel./Mobile No. 9400551243
For Office Use

Course Applied for: M.B.A.

Candidate's Thumb Impression
Male(LTI), Female(RTI)
Name : MAHESH CV
Father's Name : KUNHIRAMAN K
Address : KOTTARATHIL HOUSE,KULAPPURAM
PO VILAYANCODE,VIA MANDUR,
Specimen Signature of the
Candidate District : KANNUR State: KR
PIN Code : 6 7 0 5 0 1
Date: 2010-11-16 For Office Use

------------------------------ Fold from here ------------------------------------------------------------------ Fold from here ------------------------------------

Postage stamp(s)
of Rs. 6/- must
be affixed here
Your application for admission to
M.B.A.
Class/Course for 2010/2011 has
been received under | INSTRUCTIONS | To
Transaction ID: 8000428/MBAM | |
(1) Write your complete mailing address MAHESH CV
__________________________ | on the right hand side. |
| |
(2) Keep this card with you as a proof of KOTTARATHIL HOUSE,KULAPPURAM
| submitting your Application Form. |
| |
(3) IMPORTANT: For reference always PO VILAYANCODE,VIA MANDUR,
| quote R.No. in all your | KANNUR, KR
| correspondence/queries. |
Dealing Assistant | DEPUTY CONTROLLER | Pin Code 6 7 0 5 0 1
Date_____________ | (Admissions) |
 ALIGARH MUSLIM UNIVERSITY
Candidate’s Slip
Teacheth Man Who Knew Not

Name of the Course : M.B.A.

D.D./C.R. No : 943312, 16-11-2010, 600
(With date & amount)
Transaction ID : 8000428/MBAM
Password : 1988-05-20
Please Note: 1. Candidate is advised to regularly visit our official website
www.amucontrollerexams.com.
2. Candidate can call us on 09837043345, 0571-2700935
or email at helpdesk@amucontrollerexams.com.
3. Donot fold the form. Put it inside an A4 size envelope and
paste the postal slip on the top.
4. Kindly post the Application Form on the address given on
Page No.13 of Guide to Admissions 2010-2011

______________________________________________________

POSTAL SLIP Amount : Rs. 600

of D.D./C.R. 943312

Name of the Course: M.B.A.

To,
Deputy Controller (Admission)

Admission Section

AMU

Aligarh - 202002 (UP)

From:-
MAHESH CV

KOTTARATHIL HOUSE,KULAPPURAM

PO VILAYANCODE,VIA MANDUR,

KANNUR,KR-670501

Place of posting: