Instructions to Fill in the Application Form - Goa University
Instructions to Fill in the Application Form - Goa University
Instructions to Fill in the Application Form - Goa University
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<strong>Instructions</strong> <strong>to</strong> <strong>Fill</strong> <strong>in</strong> <strong>the</strong> <strong>Application</strong> <strong>Form</strong><br />
1. Please read <strong>the</strong> application form carefully before fill<strong>in</strong>g. <strong>Fill</strong> <strong>in</strong> <strong>the</strong> form legibly and return it <strong>to</strong> <strong>the</strong><br />
office of <strong>the</strong> Department of Computer Science & Technology, <strong>Goa</strong> <strong>University</strong> on or before Friday<br />
3 rd June, 2011(4.00 pm). Please note that no application will be received after this date and <strong>the</strong><br />
department will not be held responsible for any postal delays<br />
In case <strong>the</strong> application is be<strong>in</strong>g sent by post, send <strong>the</strong> application <strong>to</strong> :<br />
The Admission Coord<strong>in</strong>a<strong>to</strong>r, 2011 - 2012<br />
Department of Computer Science & Technology,<br />
<strong>Goa</strong> <strong>University</strong>, Taleigao Plateau,<br />
<strong>Goa</strong> 403 206.<br />
Phone: (0832) – 6519272/ 6519072 / 6519087<br />
E-mail: dcst@unigoa.ac.<strong>in</strong> / vvkamat@unigoa.ac.<strong>in</strong><br />
2. Do not attach orig<strong>in</strong>al certificates or mark sheets etc., only attested true copies or attested Xerox<br />
copies should be enclosed. Orig<strong>in</strong>al certificates and mark sheets must be brought at <strong>the</strong> time of<br />
admission fail<strong>in</strong>g which no admission will be given.<br />
3. Follow<strong>in</strong>g documents must accompany <strong>the</strong> application form.<br />
1. XIIth Std. marksheet<br />
2. Graduation year one, year two mark sheets<br />
3. Graduation f<strong>in</strong>al year mark sheet, if result is declared<br />
4. Proof of hav<strong>in</strong>g secured a score of at least 50 percentile <strong>in</strong> GA paper <strong>in</strong> <strong>the</strong> CST E-level<br />
or I-level test. The CST score entered <strong>in</strong> <strong>the</strong> application form must be identical <strong>to</strong> <strong>the</strong><br />
score <strong>in</strong> <strong>the</strong> candidate’s CST score card.<br />
5. SC/ST/OBC/PH/FF certificate wherever applicable. (Only for candidates pass<strong>in</strong>g out<br />
from <strong>Goa</strong> <strong>University</strong>)
GOA UNIVERSITY<br />
Department of Computer Science & Technology<br />
MASTERS OF COMPUTER APPLICATIONS<br />
<strong>Application</strong> <strong>Form</strong> (2011 (201 - 2012)<br />
1. NAME _____________________________________________________________<br />
_____________________________________________________________<br />
_____________________________________________________________<br />
(BLOCK LETTERS) (SURNAME) (S<br />
(FIRST NAME) E) (MIDDLE NAME)<br />
2. DATE OF BIRTH: H: _____/______/_________<br />
3. PLACE OF BIRTH: __________________________<br />
4. ADDRESS FOR CORRESPONDENCE:<br />
__________________________________________________<br />
___________________________________________________________________________________<br />
___________________________________________________________________________________<br />
5. PHONE WITH STD/ISD CODE____________________________EMAIL<br />
________________________<br />
6. CATEGORY GENERAL ENERAL SC ST OBC PH<br />
(In case of SC/ST/OBC/PH/FF attach certificate)<br />
7. WHETHER CANDIDATE HAS APPEARED/PASSED APPEARED<br />
____________<br />
DEGREE:<br />
IN FINAL YEAR OF DEGREE PROGRAM<br />
______________<br />
PASSED YEAR:<br />
8. NAME AND ADDRESS OF THE COLLEGE FROM WHICH THE BACHELOR’S DEGREE IS<br />
OBTAINED<br />
______________________________________________________________________________________<br />
______________________________________________________________________________________<br />
9. EDUCATIONAL QUALIFICATION (Beg<strong>in</strong>n<strong>in</strong>g with S.S.C. Exam<strong>in</strong>ation or Equivalent)<br />
Certificate/Degree<br />
Board/<strong>University</strong> Month &<br />
Year<br />
of Pass<strong>in</strong>g<br />
* GRADUATED FROM G O F<br />
FF<br />
Percentage<br />
Obta<strong>in</strong>ed<br />
Paste your<br />
Passport size<br />
Pho<strong>to</strong>graph<br />
Class<br />
awarded
10. CST SCORE DETAILS<br />
ROLL NUMBER ______________________ DATE OF CST EXAMINATION<br />
_______/______/__________<br />
Part A : General aptitude<br />
Paper Raw Score Score Percentile Candidates<br />
* CATEGORY G - If graduated from <strong>Goa</strong> <strong>University</strong> O - If graduated from o<strong>the</strong>r<br />
Indian Universities<br />
F - Foreign Student<br />
11. DEMAND DRAFT DETAILS :<br />
Name of Bank Branch from where<br />
D.D. Drawn<br />
DECLARATION BY THE APPLICANT<br />
D.D. Number Date when<br />
drawn<br />
Amount<br />
I hereby declare that <strong>the</strong> particulars furnished by me <strong>in</strong> this application are correct <strong>to</strong> <strong>the</strong><br />
best of my knowledge. If any <strong>in</strong>formation is found <strong>to</strong> be false/<strong>in</strong>correct at any time or if I am unable<br />
<strong>to</strong> furnish documentary proof of my qualify<strong>in</strong>g degree and percentage of marks at <strong>the</strong> time of<br />
admission, I am liable <strong>to</strong> be disqualified.<br />
DATE : ____/____/________<br />
PLACE : _________________<br />
Signature of <strong>the</strong> Applicant<br />
Important: Last date for <strong>the</strong> receipt of duly filled <strong>in</strong> <strong>Application</strong> <strong>Form</strong> at Department of Computer<br />
Science & Technology, <strong>Goa</strong> <strong>University</strong>: 3 rd June, 2011 (4.00 p.m)
____________________________________________________________________________________<br />
ACKNOWLEDGEMENT SLIP<br />
Received from Shri/Smt ……………………………………………………………………………. ………..<br />
<strong>Application</strong> for admission <strong>to</strong> <strong>the</strong> First Year of <strong>the</strong> M.C.A Course at DCST, <strong>Goa</strong> <strong>University</strong> for Academic<br />
Year 2011-2012 on …………………………<br />
By Post/Hand delivery.<br />
Date: Admission Coord<strong>in</strong>a<strong>to</strong>r 2011-2012<br />
DCST, <strong>Goa</strong> <strong>University</strong>