VARDHMAN MAHAVEER OPEN UNIVERSITY, KOTA ONLINE ADMISSION

FORM
(Formerly ‐ Kota Open University, Kota) Registra�on No.
RAWATBHATA ROAD, KOTA (RAJ.) ‐ 324021 1860412
ADMISSION cum EXAMINATION FORM
Applica�on No.
SESSION: January 2024

1. Scholar No. ‐ (For Office Use Only)

2. Programme : BA‐I/Bachelor of Arts Programme (Pass Course) Part ‐ I

3. Regional Centre : JODHPUR 4. Study Centre Code : 4003
5. Date Of Birth : 23 Jan 2005 Age as on 01 January 2024
(A�ach Cer�ficate) 18 Year(s), 11 month(s), 9 day(s)
6. Fee Details Prospectus Fee : ₹ 100
MO No. : 1860412 Registra�on Fee : ₹ 200

TR/JR/Token No. : 240603661522 Development Fee : ₹ 200

Course Fee : ₹ 2800
TR/JR/Token Date : 23 Jan 2024
Postal Charges : ₹ 200
Issuer : E‐Mitra Theory Exam Fee : ₹ 1800
Amount* : ₹ 4505 /‐ Prac�cal Camp Fee : ₹ 0 Prac�cal Exam Fee : ₹ 0
SLM/Books : NO(SLM in So� Copy)
Required
* Actual fees charged a�er selec�on of SLM op�on
Student's Bank Account Detail (View A�achment)
Account Number : 41941660905
Bank Name : SBI BANK
IFSC Code : SBIN0031729
7. Name of Applicant : HARISH GODARA
8. Father's Name : MEGA RAM GODARA
9. Mother's Name : DAMMI DEVI
10. Address for Correspondence : MATAJI KI BHAKHARI BHIYAR BARMER 9414529819
11. City : BARMER 12. District : BARMER
13. State : RAJASTHAN 14. Pin Code : 344701
15. Mobile No. : 9414529819 16. Medium of Exam : English
17. Gender : Male 18. Category : OBC
19. Domicile : Rural 20. Na�onality : INDIAN
21. Person with Disability : No 22. Religion : Hindu
23. Special Category : Not Applicable 24. Marital Status : Unmarried
25. Employment Status : Unemployed
26. Are You Regular Employee : NO
Designa�on :
Ins�tute :
Joining Date : 01/01/1900 Annual Income :0
27. Family Annual Income : Less than 1 Lac
28. Govt Id(Aadhar ) : 743168064507
29. Email ID : harishgodara1318@gmail.com
30. Domicile of Rajasthan : YES
31. Subject Op�on
 SL.NO. SUBJECT NAME
1 English Literature
2 History
3 Poli�cal Science
32. Course Op�on
SL.NO. SUBJECT NAME COURSE NAME COURSE CODE CREDIT
1 Not Applicable General Hindi QHD 0
2 Not Applicable Environmental Studies QES 0
3 English Literature Prose and Fic�on EG‐02 6
4 English Literature Poetry and Drama EG‐01 6
5 History History of Rajasthan (Earliest Time to 1956 AD) HI‐02 6
6 History History of India (Earliest Time to 1200 AD) HI‐01 6
7 Poli�cal Science Founda�on of Poli�cal Science PS‐01 6
8 Poli�cal Science Indian Poli�cal Thinkers PS‐02 6
Total Credit: 36
33. Relevant Qualifica�ons
Examina�on Passed : Intermediate/HSC/10+2 or Equivalent
Board/University : BSER
Year of Passing : 2023 Marks Obtained : 327/500
Division/Grade :1 Percentage : 65.40
Subjects : HINDI(COMP) ENGLISH(COMP) PHYSICS CHEMISTRY BIOLOG
34. Experience in related field : 0 (In Months)
35 Exam City : Barmer 36. Prac�cal Exam/Camp City :
37. ABC ID : 982979380109
38. Declara�on by Applicant

DECLARATION BY APPLICANT/आवेदक �ारा घोषणा

I hereby declare that I have read and understood the condi�ons of eligibility for the programme for which I seek admission. I fulfill the minimum
eligibility criteria and I have provided necessary informa�on in the regard. In the event of any informa�on being found incorrect or misleading, my
candidature shall be liable to cancella�on by the University at any �me and I shall not be en�tled to refund of any fee paid by me to the University.
Further, I have carefully read and understood the rules of the University as printed in the Prospectus and I accept them and shall not raise any
dispute in the future over the same rule. In case of any dispute the place of Jurisdic�on will be the kota city only.

Date :: 20‐01‐2024 18:53:00

Place : 152.58.101.160 Full Signature of the Applicant

Checklist (Please √ in relevant box)

Original Photograph & Full Signature in appropriate box given in DECLARATION BY APPLICANT
Challan for Programme fee with Name & Regis�on No.
Self A�ested Cer�ficates and Mark sheets of relevant qualifica�ons
Age Cer�ficate
Experience Cer�ficate (Wherever Applicable)
Category Cer�ficate (Wherever Applicable)
Physically Handicapped Cer�ficate (Wherever Applicable)
Widow/Divorcee Cer�ficate (Wherever Applicable)
Ex‐Service man/Kashmiri migrant/War widow Cer�ficate (Wherever Applicable)
MBA student should a�ach entrance test score card
 नोट : ऑनलाइन फॉम� क� हाड�कॉपी �व�व�व�यालय म� जमा करवाने क� आव�यकता नह�ं है | आवेदन प� क� ��त/हाड�कॉपी
अपने अ�भलेख�/�रकॉ��स म� रख� |
For Office Use Only

Form checked, found Eligible/Not Eligible for Admission.

Signature : Dealing Assistant Sec�on Officer/Assistant Registrar Regional Director

Emp. Code : _________________ _____________________ ______________________

Important Information

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Additional Information regarding BA-I/Bachelor of Arts Programme (Pass Course) Part - I by Dr. SURENDER
KUMAR KULSHRESTHA Convener/Coordinator