Application Form for Admission to, and Degree Programmesfor the Year 2012-13

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  KARNATAKA VETERINARY, ANIMAL & FISHERIES SCIENCES UNIVERSITY, BIDAR APPLICATION FOR ADMISSION TO UNDERGRADUATE DEGREEPROGRAMMES 2012-13 Read the Prospectus before filling the application.Encloseall the requiredattested copiesof Certificates, Marks card & Affidavit alongwiththeapplication and the Demand Draft(Rs. 300 for SC/ST/Cat-IandRs.600for others)andsubmit your application to the following address only The Registrar, KVAFS University, Nandinagar , Bidar-585 401 PUC College Code No FOR OFFICE USE ONLY GOK CET Reg.No. (For BVSc&AH only) Application NO.DD NO. & DateBank & BranchScrutinized byAmountVerified by1.Full name of the applicant (As entered inPUC or equivalent examination marks card) 2. Indicate the degree for which you are an applicant(write Yes or No)BVSc&AHB.Tech (D.Tech)B.F.Sc3.a) Date of Birth( Enclose copy of SSLC Marks card for proof)b) Place of Birth 4. Genderc) Taluka of Birth5. Nationalityd) District of Birth 6. Religione) State of Birth7. Mother tonguef) Age in years 8. Caste9. Indicate the category under which you are claiming the admission (vertical reservation) Enclose appropriateCertificate of category and affidavit (See prospectus) GMSC STCAT-I 2A2B3A3B9.a. If you are claiming a seat under reservation category other than GM mention your caste and sub-caste if anyCasteSub Caste Affix attestedpassport sizephotograph DateMonthYearMF  10.Indicate the Special group under which you are claiming the admission (horizontal reservation) and enclose appropriateCertificate (see prospectus)Mark (  √ ) in the box which ever is applicableRURKANNCCSPOS&GDEFEXSPDA-IND10. a If you are claiming a seat under NCC special category, specify the preference criteria as per the prospectusPreferenceMark (  √ ) 1234567810.a. If you are claiming a seat under Sports Special Category, specify the details of Medal(Gold/Silver/Bronze) secured Super ‘A’ Games A Games ‘B’ Games & participated insuper ‘A’ or ‘A’ Games‘B’ Games Mark (  √ ) in the box which ever is applicabl e 11. a. Father’s Name _______________________ b. Major occupation______________________ 12. a. Mother’s Name_______________________ b. Major occupation ______________________ 13.a. Guardian’s Name and Relationship b. Major occupation ______________________(If both the parents are not alive)14. a. Permanent Addressb. Correspondence Address__________________________________________________________________________________________________________________________________________________________________________________________Dist___________________________________________________________________________Pin code___________________________________________________________________________Phone No. & code __________________________________________________________________________Mobile Phone No. ______________________________________15. a. Are you domicile of Karnataka? (if yes, indicate under which clause you are eligible and enclose relevant documents insupport of your claim)Clause:Marks (  √) in the box which ever is applicableb. Number of full academic years studied in Karnatakac. Have you studied 1 st to 10 th standard in rural area?If yes, enclose certificate (see prospectus)No te: If your are ‘Gadinaadu’ ‘or’ Hornaadu’ Kannadiga, furnish affidavit (see prospectus) Yes / NoABCDEFGHIJKLM  16. Educational details from 1 st Standard up to II year PUC or equivalent examination (enclose relevant certificates)SlNo.Name & addressOf the school/collegeClass(es)/ Standard(s)StudiedYear of studyYear of passingStudy inRural area*Medium of Instruction**FromTo1.Primary School Education (1 to 4 th Std)2Secondary School Education (5 th to 7 th Std)3Higher Secondary School Education (8 th to 10 th Std)4I & II year PUC or Equivalent Education * Enclose Certificate in support of your study from 1 st to 10 th   Standard in Rural area for claiming reservation under rural quota (seeprospectus)** Enclose certificate in support of your study from 1 st to 10 th Standard in Kannada medium for claiming reservation under kannadaMedium study ( see prospectus)  17. a) Furnish the information about your overall performance in II year PUC or equivalent examination (enclose copies of the Marks cardof II year PUC or equivalent examination )Total marks prescribedTotal marks securedOverall percentageb) Furnish the marks obtained in PCBE subjects in the II year PUCor equivalent examination and marks obtained in PCB in CET (to befilled by the candidates who wish to apply for B.V.Sc.&AH)Physics(P)Chemistry(C)Biology(B)English(E)Aggregate in PCBE of II PUCAggregate in PCB of CETTotal MarksPercentageTotal MarksPercentagec)Furnishthe marks obtained in the following subjects in the II year PUC or equivalent examination ( to be filled by the candidates whowish to apply for (B.Tech(D.Tech) & B.F.Sc)Physics(P)Chemistry(C)Mathematics(M)Biology(B)Aggregate in PCMBTotal MarksPercentage18. Tick the preference for place of Counseling for admission19. Are you claiming seat under Agriculture QuotaIf yes submit relevant certificates/Affidavit (See page No.32-35 of prospectus)a)By Actual Cultivation/Agriculture labour/Animal Husbanry/Fisheries( to be supported by certificate – A)Rs.b)Gross salary including all allowances (to be supported by certificate-CRs.c)From Business (Certificate-B/Affidavit)Rs.d)From other sources (Certificate-B/Affidavit)Rs.TotalRs. DECLARATION I hereby affirm that the information given by me in this application is complete and true to the best of my knowledge andbelief and that I have made this application with the consent and approval of my parents/guardian. In the event of me beingadmittedto any of the constituent colleges of the University, I undertake to abide by the academic/disciplinary rules and regulations asprescribed from time to time. The University may refer for verification to any authority at any time regarding the correctness about thefacts furnished in or along with the application. In case any of the information furnished in this applicationis proved in correct orfalse, the admission granted to me in KVAFSU can be cancelled at any time during the tenure of my study in the University. Place :Date:Signature of Father/Mother/Guardian*Signature of the Applicant(* if both the parents are not alive) BANGALOREBIDARYESNO


Jan 20, 2018

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Jan 20, 2018
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