Instructions to Fill in the Application Form - Goa University

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GOA UNIVERSITY Department of Computer Science & Technology MASTERS OF COMPUTER APPLICATIONS Application Form (2011 (201 - 2012) 1. NAME _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ (BLOCK LETTERS) (SURNAME) (S (FIRST NAME) E) (MIDDLE NAME) 2. DATE OF BIRTH: H: _____/______/_________ 3. PLACE OF BIRTH: __________________________ 4. ADDRESS FOR CORRESPONDENCE: __________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ 5. PHONE WITH STD/ISD CODE____________________________EMAIL ________________________ 6. CATEGORY GENERAL ENERAL SC ST OBC PH (In case of SC/ST/OBC/PH/FF attach certificate) 7. WHETHER CANDIDATE HAS APPEARED/PASSED APPEARED ____________ DEGREE: IN FINAL YEAR OF DEGREE PROGRAM ______________ PASSED YEAR: 8. NAME AND ADDRESS OF THE COLLEGE FROM WHICH THE BACHELOR’S DEGREE IS OBTAINED ______________________________________________________________________________________ ______________________________________________________________________________________ 9. EDUCATIONAL QUALIFICATION (Beginning with S.S.C. Examination or Equivalent) Certificate/Degree Board/University Month & Year of Passing * GRADUATED FROM G O F FF Percentage Obtained Paste your Passport size Photograph Class awarded
10. CST SCORE DETAILS ROLL NUMBER ______________________ DATE OF CST EXAMINATION _______/______/__________ Part A : General aptitude Paper Raw Score Score Percentile Candidates * CATEGORY G - If graduated from Goa University O - If graduated from other Indian Universities F - Foreign Student 11. DEMAND DRAFT DETAILS : Name of Bank Branch from where D.D. Drawn DECLARATION BY THE APPLICANT D.D. Number Date when drawn Amount I hereby declare that the particulars furnished by me in this application are correct to the best of my knowledge. If any information is found to be false/incorrect at any time or if I am unable to furnish documentary proof of my qualifying degree and percentage of marks at the time of admission, I am liable to be disqualified. DATE : ____/____/________ PLACE : _________________ Signature of the Applicant Important: Last date for the receipt of duly filled in Application Form at Department of Computer Science & Technology, Goa University: 3 rd June, 2011 (4.00 p.m)
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Instructions to Fill in the Application Form - Goa University

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