residential courses (rcat) - Dr. Ram Manohar Lohia Avadh University

12. Details of Earlier Examinations Passed
fiNyh mRrh.kZ ijh{kkvksa dk fooj.k
S.N.
dz-la-
Class
d{kk
1. High School
¼gkbZ Ldwy½
2. Intermediate
¼b.VjehfM,V½
3. B.A. I/ B.Sc. I/ B.Com.I
ch-,- I@ch-,llh- I@ch-dke- I
4. B.A. II/ B.Sc.II/ B.Com.II
ch-,- II@ch-,llh- II@ch-dke- II
5. B.A.III/B.Sc.III/B.Com.III
ch-,- III@ch-,llh- III@ch-dke- III
6. Any others
vU; dksbZ
University/
Board
fo'ofo|ky;
@cksMZ
Year
o"kZ
Subject(s)
fo"k;
Max. Marks
vf/kdre vad
Marks
Obtained
izkIrkad
Division/
Percentage
Js.kh@izfr’kr
Remarks
fooj.k
13. Weightage Details/Hkkjkad fooj.k
For filling these details refer Table- II of Guidelines. (bu fooj.kksa dks Hkjus ds fy, funsZf'kdk ds lkj.kh-II dks ns[ksa½
Weightage Category A B C D E F Total
Weightage
14. No. of enclosures/layXudksa dh la[;k% …….......…
Checked by
Signature:
Name:
Weightage Allowed/ vuqeU; Hkkjkad
(For office use only/ dsoy dk;kZy; iz;ksx gsrq½)
DECLARATION AND OATH BY THE APPLICANT/ vH;FkhZ }kjk ?kks"k.kk ,oa 'kiFk
1. I, hereby, declare that the information given herein is correct to best of my knowledge and belief.
eSa ?kks"k.kk djrk@djrh gWwa fd mi;qZDr fooj.k esjs laKku ,oa fo'okl esa lgh gSA
2. I will abide by all rules/regulations for admission of University and attend the class/course as per requirement of the University,
if selected for admission.
eSa fo’ofo|ky; }kjk izos’k gsrq p;fur gksus ij izos’k lEcU/kh fo'ofo|ky; ds lHkh fu;eksa dk ikyu d:Waxk@d:Waxh rFkk fo’ofo|ky; }kjk fu/kkZfjr U;wure d{kk@O;k[kku
iwjk d:Waxk@d:WaxhA
3. I will not indulge myself in any ragging/unlawful activities during studies.
eSa v/;;u ds nkSjku fdlh Hkh izdkj ds jSafxax@xSjdkuwuh xfrfof/k;ksa esa lfEefyr ugha jgWwxk@jgWwaxhA
4. Even if I qualify the admission test but fail to obtain minimum eligibility criteria or fail to produce certificate/marksheet of
qualifying examination as proof of possession of minimum prescribed qualifying qualification prescribed for admission in the
qualifying examination, my candidature for admission shall be rejected.
;fn eSa izos’k ijh{kk esa lQy gksrk gwWa] ijUrq vgZdkjh ijh{kk esa U;wure fu/kkZfjr vgZrk ugh izkIr djrk gWw vFkok izos'k gsrq fu/kkZfjr U;wure ekud vuqlkj vgZdkjh ijh{kk dk
vad i=@mikf/k izLrqr djus es vleFkZ jgrk@jgrh gWaq rks izos'k gsrq esjh vH;fFkZrk fujLr ekuh tk;sxhA
5. I have not been convicted in any criminal case and no criminal case is pending against me in the Court.
eSa fdlh vkijkf/kd ekeysa esa nks"kh ugh gWaw rFkk esjs fo:) dksbZ vkijkf/kd ekeyk U;k;ky; esa yfEcr ugh gSA
6. I have not been prevented from taking any examination on the basis of using unfair means at any exam.
eq>s fdlh Hkh ijh{kk esa vuqfpr lk/ku iz;ksx djus ds vk/kkj ij ijh{kk ls oafpr ugh fd;k x;k gSA
Signature of the Father/Guardian Date & Place Signature of Applicant
firk@vfHkHkkod ds gLrk{kj fnukWad ,oa LFkku vkosnd ds gLrk{kj
Enclosures/layXud%&(a)
(b)
(c)
(d)
Note/uksV&
Recent Caste Certificate on the latest format prescribed by U.P. Govt. (Clearly mentioning Creamy-layer for
O.B.C. Candidates)& Certificate for horizontal reservation/ mRrj izns'k ljdkj }kjk fu/kZfjr v|ru izk#i ij tkjh tkfr
izek.k&i= ¼ftlesa vU; fiNM+k oxZ vH;fFkZ;ksa ds dzhehys;j esa u gksus dk Li"V o.kZu gks½ ,oa {kSfrt vkj{k.k gsrq izek.k&i=%
High School Marks Sheet/Certificate clearly mentioning Date of Birth gkbZLdwy vadi=@izek.k&i= ftlesa tUe frfFk dk
fooj.k gksA
Weightage Certificate/Hkkjkad izek.k&i=
Marks-Sheet of qualifying examination / vgZdkjh ijh{kk dk vad&i=
Application form not duly signed by the applicant shall be rejected. / vkosnu i= vH;FkhZ }kjk Lo;a lR;kfir u fd;s tkus
ij fujLr dj fn;k tk;sxkA