IT Repeaters Exam Application Form - Kuvempu University
IT Repeaters Exam Application Form - Kuvempu University
IT Repeaters Exam Application Form - Kuvempu University
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Please take a printout of application in below two pages
KUVEMPU UNIVERS<strong>IT</strong>YDIRECTORATE OF DISTANCE EDUCATIONOffice of the Director, Jnanasahyadri, Shankaraghatta-577 451Shimoga District, Karnataka State, Phone :08282 256450, 256246, 256426EXAMINATION APPLICATION FORM FOR REPEATERS 2011-12(B.Sc (<strong>IT</strong>), M.Sc (<strong>IT</strong>) & B.Sc (<strong>IT</strong>IM))Note: 1) Please carefully read the information given at the back ofthis <strong>Form</strong> before filling up.2) Fill – up all details correctly & legibly.Affix apassport sizephoto of theapplicant1 Name of the Applicant(in capitals as registered in KU)2 Roll/Registered Number(as assigned by <strong>University</strong>)3 Name of the Study CentrePlaceStudy Centre Code4 Address for Communication56Contact NumberCourse (put √ mark beside theappropriate courseMonth & Year of <strong>Exam</strong>inationappearing for7 Subjects/Papers appearing:SL12345678910SemesterSubjectCodeB.Sc(<strong>IT</strong>) M.Sc(<strong>IT</strong>) B.Sc (<strong>IT</strong>IM)Name of Subject/PaperFee paid (referinstructions)Continued in page 2
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