Central University of Kerala

(Estd. under the Central University Act 2009), Tejaswini Hills, Pariye(PO), Kasaragod(DT), Kerala-671316, INDIA
Admission Application Form

Date & Time : 02-11-2021 14:51:10

Admission Year: 2021- 22

Personal Details:

Application No :PG219602 Aadhaar No :530488881627

Candidate Name :KUMARI DIKSHA Email Id. :dikshasingh11118@gmail.c
om
Date of Birth :13/01/1997 Mobile :7970546884
Father's Name :JAGDIP KUMAR Domicile State :Bihar
Mother's Name :BABITA SINGH Nationality :INDIAN
Gender :Male Religion :Hindu

Category :GENERAL Whether Person with :No

Disability(PWD)
Kashmiri Migrants :No Ward of defence :No
personnel

Communication Details
Communication Address Permanent Address
Address Line 1 :VILL GIDHA, POST GIDHA , Address Line 1 :VILL GIDHA, POST GIDHA ,
PS KOILWAR BHOJPUR , PS KOILWAR BHOJPUR ,
BIHAR 802314 BIHAR 802314
Address Line 2 :VILL GIDHA, POST GIDHA , Address Line 2 :VILL GIDHA, POST GIDHA ,
PS KOILWAR BHOJPUR , PS KOILWAR BHOJPUR ,
BIHAR 802314 BIHAR 802314
State :Bihar State :Bihar
City :Bhojpur City :Bhojpur
Pin Code :802314 Pin Code :802314

Academic Details:

S.No. Name of Subject of the School/College Board/University Year of Percentage/

Examination Examination Name name passing CGPA

1 10th HINDI, SANSKRIT, KANYA HS KULHARIYA BIHAR SCHOOL 2012 54.60

MATHEMATICS, EXAMINATION BOARD,
SCIENCE, SOCIAL PATNA
SCIENCE, ENGLISH

2 12th RB NON- HINDI, T S I MAHILA COLLEGE BIHAR SCHOOL 2014 58.20

ALTERNATIVE ENGLISH, ARA BHOJPUR EXAMINATION BOARD,
HINDI, PSYCHOLOGY, PATNA
HISTORY, SOCIOLOGY

3 UG LAW LOVELY PROFESSIONAL LOVELY PROFESSIONAL 2021 7.64

UNIVERSITY UNIVERSITY

Programme Details

S.No. Department Programme Confirm Test Paper Cucet Preference Confirm

Eligibility Code Score

1 Law L L M-(Master of Law) Yes PGQP02 184 1 Yes

Marksheet and Other Documents

S.No Documents File Name Is UnderTaking

1 CUCET Admit Card PG219602_CUCET Admit Card.pdf

2 CUCET Score Card PG219602_CUCET Score Card.pdf

3 Transfer Certificate PG219602_Transfer Certificate.pdf N

4 Degree Certificate or Provisional Certificate PG219602_Degree Certificate or Provisional N

Certificate.pdf

5 Course Completion Certificate PG219602_Course Completion Certificate.pdf N

6 Conduct Certificate PG219602_Conduct Certificate.jpeg N

7 SSLC or Matriculation Certificate PG219602_SSLC or Matriculation Certificate.pdf N

8 +2 or PUC or PDC or HSC Certificate PG219602_+2 or PUC or PDC or HSC Certificate.pdf N

9 Degree Mark List Year or Semester wise PG219602_Degree Mark List Year or Semester N
wise.pdf

10 Aadhar Card Copy or E-Aadhar PG219602_Aadhar Card Copy or E-Aadhar.jpeg N

11 Any other relevant document PG219602_Any other relevant document.pdf

12 Migration Certificate PG219602_Migration Certificate.pdf N

Declaration
We hereby declare that the information given above is the true. I hereby undertake to pay the fee and other charges

as prescribed from time to time and to abide by the rules and regulations in force as amended by the university from time to time.

Date:02-11-2021 14:51:11 Parent's Signature Signature