KERALA UNIVERSITY OF FISHERIES AND OCEAN STUDIES PANANGAD P.O., KOCHI -682506 Affix passport size photograph APPLICATION FOR ADMISSION TO PG/Ph.D/PDF/ DIPLOMA COURSES FOR THE YEAR 2018-19 1. Name of candidate in full (as recorded in the SSLC) (a) (b) In English (block letters) In mother tongue 2. Name of Father/ Guardian (Mention relationship with Guardian) 3 Name of Mother 4 Date of Birth 5. Age in years 6 Gender Male/Female/Transgender 7 Nationality Indian/NRI/PIO/OCI/Foreign Candidate 8. State of Domicile 9. Religion 10. Caste Category General/ SC/ST/ SEBC/OBC 11. Are you eligible for community reservation? Yes/No 11.a If yes, Whether belonging to SC/ST of Kerala origin 11.b If yes, name of the caste. (community certificate should be attached) Yes/No 12. Do you belongs to SEBC/OBC/ OEC Yes/No 12.a. If yes, Sub Caste Category Ezhava (EZ)/ Muslim (MU)/ Other Backward Hindu (BH)/ Latin Catholic and Anglo Indian (LC-AI)/ Dheevara and related communities (DV)/ Viswakarma and related communities (VK)/ Pot making caste (KN)/ Other Backward Christian (BX)/ Kudumbi (KU) 1
12.b. Caste 12.c. Do you belong to Creamy Layer? (Candidate belonging to creamy layer is not eligible for any community reservation) 13.Address for communication (with PIN code) Yes/No 14. Permanent address in full (with PIN code) 15. Email Id of the student 16. Mobile Number of the student 17. Parents/Guardian Mobile number 18. Are you eligible for Special reservation category? Yes/No (Children of ex-serviceman/ Children of fishermen/ Foreign nationals/ Kashmiri migrants/ Physically challenged/ Sponsored candidates by Govt. Department/ Sports quota). 18.a. If yes, name the category* Children of ex-serviceman/ Children of fishermen/ Kashmiri migrants/ Physically challenged**/ Sponsored candidates by Govt. Department/ Sports quota. * produce copies of relevant certificates Note: ** if physically disabled, certificate to prove disability as per the persons with disabilities (equal opportunities, protection of rights and full participation) Act 1995 should be produced 2
19. Educational Qualifications (Enter Education qualification from matriculation) Name of Course Name of the Board Year of passing Total aggregate marks Grade /Percentage secured out of max. of. Remarks Note: Self attested true copies of mark list (Transcripts) should be attached separately. 20. Name of course applied for (with specialization) (The candidate can apply for 5 courses by paying admission fee of Rs 1000/-( For SC/ST Rs. 500) ; 6-10 courses by paying Rs.2000 ( For SC/ST Rs 1000/-); 11-15 course by paying Rs 3000/- (For SC/ST 1500/-) 1. 2. 3. 4. 5 6 7 8 9 10 11 12 13 14 15 3
20a. If applying for MBA, specify the score obtained in any of the following exams. (1) GMAT (2) CAT (3) XAT (4) MAT (5) KMAT 20b. If applying for PDF, specify the following Title of thesis and Name of guide Number of publications in peer reviewed journals (If required separate sheets can be used as Annexure. Copy of the first page of publications should be enclosed) 21. (a) Place of Birth (b) Village/Taluk (c) District 22 Mother tongue 23. Height...cm, Weight..Kg, Blood Group. 4
24.Name and address of the local Guardian, if any \ 25. Aadhar card No. of the candidate 26. Annual income of Parents/Guardian 27. Whether employed or not, if employed furnish details: Post/Designation Institution/Department 28. Other relevant information, if any 29. Details of application fee paid DD No/Challan Date: 30.Checklist 1. Proof for Date of birth 2. Proof for qualification 3. Original challan receipt 4. Proof for reservation (if any) SBI Branch : Amount in Rs Filled in applications may be sent to The Registrar, Kerala University of Fisheries and Ocean Studies, Panangad P.O., Kochi -682 506 The cover should be superscribed as 'Application for... PG/PhD/PDF/Diploma programme DECLARATION BY THE CANDIDATE I hereby declare that the information furnished by me is true to the best of my knowledge and belief. I have given my preference of courses and I shall not claim on any other course than what is mentioned in preferred courses. I have not been detained from appearing for any examination held by Govt. /Govt. controlled institutions/organizations in India. I understand that, if at any stage, it is found to the University that the information provided by me is false or misleading, my application shall be summarily rejected without further notice, apart from the liability for such penal action as warranted by law. Place: Date: Name and Signature of the Applicant 5
KERALA UNIVERSITY OF FISHERIES & OCEAN STUDIES PANANGAD P.O., KOCHI 682 506, KERALA, INDIA 0091-484-2703782, 2700598; Fax: 0484-2700337 e-mail: utypanangad@kufos.ac.in web: www.kufos.ac.in HALL TICKET ENTRANCE EXAMINATION 2018-19 ENTRANCE EXAMINATION FOR THE.. PROGRAMME REG. No: Test Code:... Name of the Candidate (in block letters) : Signature of the candidate: Affix Self Attested passport size photograph VENUE : KUFOS H.Q., Panangad, Kochi - 682506 DATE & TIME :... NB: Candidates shall report in the examination hall 30 minutes before the commencement of the examination with original identity proof (Voters Id/Aadhar card/driving license/passport/identity card issued by Educational Institute/Identity card issued by Govt. organizations/ Bank pass book with photograph issued by Nationalised Banks). Those who come after the commencement of the examination will not be permitted to write the examination. Similarly candidates will be allowed to leave the examination hall only 60 minutes after the commencement of the examination. No electronic equipments including mobile phones, calculators, etc., will be allowed in the examination hall. The candidates, who commit any malpractices, will be debarred from the examination. For office use REG. No: Test Code:... Name and Signature of the candidate : Signature of the Invigilator : 6
KERALA UNIVERSITY OF FISHERIES AND OCEAN KERALA UNIVERSITY OF FISHERIES AND OCEAN KERALA UNIVERSITY OF FISHERIES AND OCEAN STUDIES (KUFOS) STUDIES (KUFOS) STUDIES (KUFOS) PANANGAD PANANGAD PANANGAD Fee Payment Voucher Fee Payment Voucher Fee Payment Voucher Student Copy University Copy Bank Copy Paid into the credit of Kerala University Of Fisheries Paid into the credit of Kerala University Of Fisheries Paid into the credit of Kerala University Of Fisheries And Ocean Studies (Kufos), Panangad. And Ocean Studies (Kufos),Panangad And Ocean Studies (Kufos),Panangad Account No. 67277732022 Account No. 67277732022 Account No.. 67277732022 Rupees Rupees Rupees Name of Degree: Name of Degree: Name of Degree: BRANCH: SEMESTER: BRANCH: SEMESTER: BRANCH: SEMESTER: PURPOSE OF REMITTANCE CODE Rs PURPOSE OF REMITTANCE CODE Rs PURPOSE OF REMITTANCE CODE Rs Application/Admission A Application/Admission A Application/Admission A Tuition fee B Tuition fee B Tuition fee B Special fee C Special fee C Special fee C OTHERS D OTHERS D OTHERS D TOTAL TOTAL TOTAL NAME & ADDRESS OF THE STUDENT(IN CAPITAL LETTERS): NAME & ADDRESS OF THE STUDENT(IN CAPITAL LETTERS): NAME & ADDRESS OF THE STUDENT(IN CAPITAL LETTERS): REFERENCE NO /ADMISSION NO REFERENCE NO /ADMISSION NO REFERENCE NO /ADMISSION NO NAME OF BRANCH WHERE AMOUNT IS REMITTED NAME OF BRANCH WHERE AMOUNT IS REMITTED NAME OF BRANCH WHERE AMOUNT IS REMITTED DATE OF DEPOSIT DATE OF DEPOSIT DATE OF DEPOSIT SIGNATURE OF REMITTER SIGNATURE OF REMITTER SIGNATURE OF REMITTER For Bank's use For Bank's use For Bank's use Journal No Journal No Journal No *This Challan can be used for remittance at any branch of State Bank of India, at a service charge of Rs.20/ only as per sanction from appropriate authority. Branches be guided by C&I Circular No.28/2009 dated 08th December,2009