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(ANNEXURE-V)
UNIVERSITY COLLEGE, KURUKSHETRA
CULTURAL ACTIVITIES
Session 2014- 15
Note : WRITE ALL THE PARTICULARS IN CAPITAL LETTERS
1. Name of the Student ___________________________________________
2. Date of Birth _________________________________________________
3. Father’s Name & Occupation_____________________________________
4. Mother’s Name & Occupation____________________________________
5. Class ____________________________________________________
6. Roll No. ____________________________________________________
7. University Regn. No.___________________________________________
8. Blood Group__________________________________________________
9. Special Hobbies_______________________________________________
Paste Carefully
Recent Coloured
Photograph
_________________________________________________________________
10. Cultural Activities
Participation/Achievements
EVENT WHERE HELD YEAR POSITION
11. Subjects Offered 1. ______________ 2 ______________ 3 ______________ 4 ______________
12. Permanent Address ____________________________________________________________________________
With Phone No.
_____________________________________________________________________________
13. Hostel Address _______________________________________________________________
with Phone No
14. Correspondence Address___________________________________________________________
with Phone No. ________________________________________________________________
I declare that the above information is correct. I shall also abide by all the rules and shall
participate in cultural activities selflessly.
Dated
…..………………………………………………
Recommendation of the Incharge/ Co-ordinator
……………………………
Signature of the Student
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