KARNATAKA STATE OPEN UNIVERSITY

Mukthagangotri, Mysuru-570006

Application Number : 20120236 Date : 31/12/2020

Online admission Application for M.B.A I YEAR 2020-21 July Session Level: NA

Applicant's Basic Details

Name SAPNARANI
Father/Husband/Guardian
Name JAGANATHREDDY

Mother Name SHASHIKALA

Email Id appaeducationtrust2015@gmail.com

Mobile 9686547667

Date of Birth 26/11/1998

Gender FEMALE

Nationality Indian

Domicile State KARNATAKA Category IIIB

Bank Account Number 3410101004432 Caste REDDY

Account Holder Name SAPNARANI Sub Caste REDDY

Bank Branch Name CANARA BANK, HUMNABAD Religion HINDU

Bank IFSC Code CNRB0003410

Communication Address

1-13/3 NEAR LAXMI TEMPLE NAGANKERA BIDAR KARNATAKA - 585329

Applicant's Program Details

Program & ProgramType M.B.A I YEAR

Regional Centre KALBURGI

Study Centre ANANYA DEGREE AND MSW COLLEGE KALABURGI - BA/BCOM

Medium of Instruction ENGLISH

Applicant's Subjects Details

OPTIONAL M.B.A
SKILL DEVELOPMENT SUBJECT COMMUNICATION SKILLS
Applicant's Other Details

Aadhaar Number 790693751156

Applicant Profession STUDENT

Applicant's Quota Details

Differently Abled No

Defence No

Rural Yes

Urban No

BPL(Womens Only) No

Kalyana Karnataka(HK) Yes

 KARNATAKA STATE OPEN UNIVERSITY
Mukthagangotri, Mysuru-570006

Applicant's Qualification Details

Qualification Board /University Year of Pass Register No

SSLC KSEEB 2015 20150543062

PUC PUC 2017 520756

BCOM AKKAMAHADEVI WOMESN'S UNIVERSITY,VIJAYPURA 2018 17366064

Applicant's Processing fee payment details

Application No Course Payment Id Amount Paid Date

Applicant's Admission fee payment details

Application No Course Payment Id Amount Paid Date

20120236 M.B.A pay_GJcR0F4Ak65GF8 18,500.00 31/12/2020 4:17:10PM

Declaration by the Applicant

I do hereby declare that information furnished is true and correct to the best of my knowledge and belief. I agree to
the Terms and Conditions for given in the University prospectus.

Signature of the Applicant

UNDERTAKING

I understand that it is my responsibility to note of the relevant regulations of the course for which I am admitted in this
University and to satisfy the requirements in full. I will abide by the rules of CONDUCT and DISCIPLINE imposed by the
University and abstains from practicing RAGGING in any form. Further, I declare that I shall be responsible if I fail to
satisfy any of the conditions. I understand that the University is at liberty to take such suitable action as it deems fit
against me in the event of not registering SATISFACTORY PROGRESS and possessing SATISFACTORY CONDUCT.

Date : Signature of the Applicant

Place : SAPNARANI

For Office Use Only

Application No Roll Number Course Date of Admission

20120236 M.B.A I YEAR

Payment Date Payment Id Payment Fee Paid Fee in Rupees

Status Amount
31/12/2020 pay_GJcR0F4Ak65GF8 Success 18500.00 Rupees Eighteen Thousand Five Hundred Fifty Only.

Total Fee 18500.00 Rupees Eighteen Thousand Five Hundred Only.

Case Worker Superintendent Regional Director