Application forms - Dibrugarh University

APPLICATION FORM FOR APPEARING IN THEDIBRUGARH UNIVERSITY POST GRADUATE ENTRANCE TEST, 2012(DUPGET)To be submitted at the TEST CENTREconcerned, where the applicant intends toappear. In case of D.U., the forms have to besubmitted at the Office of the Dy. Registrar(Academic). Last date of Submission is15.06.2012Affix passportsize colouredphotographSubject:DIBRUGARH UNIVERSITYDibrugarh 786 0041. Name of the candidate in Full: (BLOCK LETTERS)Surname Name Middle NameMR./MS.2. Address for Correspondence:………………………………………………………………….……………………………………………………………………………………………………..………………………………………………………………………………………………………PIN…………………………….Mobile No. ……………………..e-mail ID:………………………3. Father’s Name:……………………………………..………………………………4. Mother’s Name:……………………………………..………………………………5. Date of Birth: Day Month Year(According to the School Leaving Certificate)6. Sex: (Please tick on the relevant box) Male Female7. Educational Qualification:Examinationpassed (OnlyGraduation)DegreeUniversityRollNoYear ofPassingDiv /ClassPercentage ofMarks/GradeSubjects takenRemarks

DIBRUGARH UNIVERSITY POST GRADUATE ENTRANCE TEST, 2012(DUPGET)ATTENDANCE SLIP FOR USE AT THE TEST CENTRE(TO BE KEPT WITH THE OFFICER-IN-CHARGE FOR USE ON THE DAY OF EXAMINATION)NAME OF THE CANDIDATE:__________________________________Subject:______________________________________________________Name of the Test Centres: 1. Dibrugarh University(Please tick on the relevant box)2. J.B. College3. Lakhimpur Girls’ CollegeRoll No.Affixpassport sizecolouredphotograph(For Official use)Date of DUPGET: 30.06.2012/ 01.07.2012Time: 11.00 A.M. - 01.00 P.M.Signature of the CandidateSignature of the Officer-in-Charge(The candidate shall sign here on the dayof DUPGET in front of the Invigilator)------------------------- ------------------------ --------------------------- ------------------------------------DIBRUGARH UNIVERSITY POST GRADUATE ENTRANCE TEST, 2012(DUPGET)Roll No.(For official use)Date of DUPGET: 30.06.2012/ 01.07.2012ADMIT CARDTime: 11.00 A.M. - 01.00 P.M.AffixpassportsizecolouredphotographSubject:______________________________________________________Name of the Candidate________________________________________________Name of the Test Centre:______________________________________________Father’s / Mother’s Name______________________________________________Address for Correspondence ___________________________________________________________________________________________________________________________________ PINSignature of the CandidateSignature of Officer-in-Charge