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Application Form Number
WCA
AMRITA
VISHWA VIDYAPEETHAM
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ESTABLISHED U/S 3 OF U.G.C. ACT 1956
ACCREDITED BY NAAC WITH ‘A’ GRADE
AMRITA SCHOOL OF ARTS AND SCIENCES
BRAHMASTHANAM, EDAPPALLY NORTH P.O., KOCHI – 682 024, KERALA, INDIA.
PHONE: 0484 - 2802899, 2801489, 2801965. FAX: 0484 - 2802511
E-mail ID: [email protected]
APPLICATION FORM FOR ADMISSION (2014) TO UNDER - GRADUATE PROGRAMME
BACHELOR OF COMPUTER APPLICATIONS [B.C.A.]
*Under – Graduate programmes [B.C.A., B.Com., B.B.M. and B.Sc. (VM)
are offered only for GIRLS
[Please read the “INSTRUCTIONS TO CANDIDATES” and “FAQ“ before filling this Application Form. All entries to be
made in BLOCK LETTERS. Fill in all the details IN CANDIDATES OWN HANDWRITING. INCOMPLETE APPLICATION FORM
is liable for rejection. Enclose ONLY self – attested photocopies of Marklists.]
1.
Name of the Applicant as
given in the S.S.L.C. Book (leave blank space between first name and initials)
2.
Date of birth : (Date)______(Month) ______ (Year)___________Completed Age:______
3.
Gender: FEMALE*
4.
Place of Birth: ________________________________
Affix recent
District: _________________________ State: _______________________
Passport size
Blood Group: _________
photograph
5.
Religion:____________Caste:____________ Community (SC/ST/OBC/OEC/Gen/Others)_________
6.
Mother Tongue:___________________
7. Nationality:________________
8 (a). Address for Communication: __________________________________________________________________
__________________________________________________________________
Post Office:__________________________________________________________________
District:_____________________State:_____________________ Pin Code: ___________
Phone No. (with STD Code):_______________________ E-mail:________________________________________
Father’s Mobile Number:_______________________
Mother’s Mobile Number:_________________________
Father’s E-mail ID: ___________________________
Mother’s E-mail ID: ______________________________
8 (b). Permanent Address: ________________________________________________________________________
_________________________________________________________________________
Post Office:_________________________________________________________________________
District:_______________________State:_______________________ Pin Code: _____________
Phone No. (with STD Code): ___________________________E-mail:_________________________________
Alternate contact Phone (Mobile and Landline with STD Code)
with the name of the person and relationship with the student: _______________________________________
Page 1 of 4
9 (a).
Father’s Name: ______________________________________________________________________________
Occupation (specify) _______________________________________ Annual Income ______________________
Office Address with Phone No. (if any) ___________________________________________________________
___________________________________________________________________________________________
9 (b).
Mother’s Name: ______________________________________________________________________________
Occupation (specify) _______________________________________ Annual Income ______________________
Office Address with Phone No. (if any) ___________________________________________________________
___________________________________________________________________________________________
9 (c). Do you have Brothers or Sisters? If yes, give their names:________________________________________________
10. Name and address of Local Guardian (if any) __________________________________________________________
___________________________________________________________
Post Office:___________________________________________________________
District:___________________State:____________________ Pin Code: __________
Phone No. (with STD Code) _____________________________ Mobile No. _____________________________
E-Mail ID____________________________________________Relationship with student: _____________________
11. Name of the School / Institution last studied for the qualifying examination:
a)
Name of the School / Institution: _____________________________________________________________
b) Address with Pincode: _____________________________________________________________________
c)
Group: __________________________________________________________________________________
d) Month and Year of passing: _________________________________________________________________
e)
Board / University: ________________________________________________________________________
f)
Subjects studied:__________________________________________________________________________
12. What is the present stage of your study: Course completed / Appeared in final examination / Result awaited / Qualified
(strike out whichever is not applicable)
13. Marks obtained in the qualifying examination:
(Enclose self - attested photocopies of 10th and 12th mark sheets)
Class
th
Marks Obtained
Maximum Marks
% of Marks
No. of Attempts
10
th
12
14. Major Extra Curricular Activities
Year
No.
Activity
From
To
Page 2 of 4
Honours
Received (if any)
Remarks
15. Reason for choosing the AMRITA school for your studies:
…………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………
16. How did you come to know of Amrita School of Arts and Sciences, Kochi campus?
The Hindu
Indian Express
Matrubhumi
Malayala Manorama
Janmabhumi
Kerala Kaumudi
Amrita Website
Alumni
M.A.MATH
Matruvani
Other Institutions
School / Institution last studied
TV Channel
Others________________________________________
DECLARATION BY THE APPLICANT
I ________________________________________D/o. of ___________________________________________________
hereby declare that the particulars given by me in this Application Form are true. I shall produce the original certificates at
the time of admission. I confirm having read and understood the “Instructions to Candidates” and “FAQ” before filling this
Application Form.
Place:
(Signature of the applicant)
Date:
Name: _________________________
Page 3 of 4
DECLARATION BY PARENT / GUARDIAN
I,
____________________________________
undertake
the
responsibility
of
my
daughter/ward
_________________________________ who is seeking admission in the Amrita School of Arts and Sciences, Kochi
Campus of Amrita Vishwa Vidyapeetham and declare that the particulars furnished by her is correct and true and that if in
future, any information is found to have been furnished falsely or incorrectly or any information suppressed to secure
admission, I shall withdraw my daughter / ward from the course without any claim or consideration of the period of
study/stage of the course she completed. I hereby ensure that the candidate has read the “Instructions to Candidates” and
“FAQ” before filling this Application Form. I shall not claim refund of fees already paid in the event of discontinuance of
the study.
(Name and Signature of Parents)
Father: _________________________
Mother: ________________________
Name and Signature of Guardian (If Applicable):___________________________ __
Place:
Date:
I fully agree with the above declaration.
I fully agree to abide by the rules and regulations of
Amrita School of Arts and Sciences, Kochi if admitted to
the course.
(Signature of the applicant)
Name: _________________________
FOR OFFICE USE ONLY
Fees Paid: Rs. _________________________
Semester: __________________________
Rt. No. ______________________________
C.D.Rt. No. ________________________
D.D_________________Dt. _____________
Bank. _____________________________
Page 4 of 4
AMRITA SCHOOL OF ARTS AND SCIENCES, KOCHI
PHONE: 0484 - 2802899, 2801489, 2801965. FAX: 0484 - 2802511
Website: http://amrita.edu/asas/kochi
E-mail ID: [email protected]
INSTRUCTIONS TO CANDIDATES (ADMISSION - 2014)
1. Please read the PROSPECTUS, FAQ & the INSTRUCTIONS GIVEN BELOW carefully
before filling the Application Form.
2. Under – Graduate programmes [B.C.A., B.Com., B.B.M. and B.Sc. (Visual Media) are
offered only for GIRLS. 5 year Integrated M.A. (English Language and Literature) are
offered for both BOYS and GIRLS.
3. Candidates who have appeared or are appearing for their final qualifying examination IN FULL are
also eligible to apply. Their admission will be subject to passing the qualifying examination at
the time of admission.
4. Application Form downloaded from our Website may also be used. Such Application Forms should
be sent to us along with a DEMAND DRAFT for Rs. 650/- in the case of M.C.A., Rs. 500/- in the
case of other P.G. programme and Rs. 400/- in the case of U.G. programme and Integrated
M.A. programme drawn in favour of “AMRITA VISHWA VIDYAPEETHAM”, payable at
Kochi. Demand Draft can be taken from any Bank. CHEQUES WILL NOT BE ACCEPTED.
5. Cost of Application Form does not include charges for any other services.
6. All details and information asked for in the Application Form should be filled-in. This must be
done in BLOCK LETTERS in CANDIDATES OWN HANDWRITING.
7. Do not enclose any original certificates with Application Form. Please enclose self - attested
photocopies only. (Refer to the ‘Checklist for Enclosures’ given on Page No. - 2)
8. INCOMPLETE APPLICATION FORM will be liable for rejection.
9. Separate Application Forms should be submitted for different courses including separate
Demand Draft.
10. The candidates must produce, at the time of counseling for admission, original certificates /
marklists of S.S.L.C. or equivalent (10th ), HSE / CBSE or equivalent (12th), Degree marklists /
grade sheets (all semesters / years), Provisional Certificate (if available), Course and Conduct
Certificate, Transfer Certificate and Degree Certificate (if available).
11. Applicant should write the name of the Course applied for, on top of the envelope while
posting the Application Form.
12. Completed Application Forms for U.G. and P.G. Courses is to be returned to the address
given below by Hand / Speed Post / Registered Post / Courier.
DIRECTOR
AMRITA SCHOOL OF ARTS AND SCIENCES,
BRAHMASTHANAM,
EDAPPALLY NORTH P.O.,
KOCHI – 682024
KERALA.
Phone: 0484 - 2802899, 2801489, 2801965.
Fax: 0484 - 2802511
LAST DATE for submission of Application Forms for U.G. is on or before
10th JUNE 2014 (Tuesday)
13. Application Forms received after the LAST DATE will not be considered.
14. Only the candidates who are short - listed for counseling / interview / selection process will
receive communications from Amrita School of Arts and Sciences, Kochi.
15. No communications will be sent to those who are not short - listed.
16. Amrita School of Arts and Sciences, Kochi will not provide any transport for the candidates to
appear for the Counseling / Interview / any selection process.
17. For any further clarifications contact the Office of Amrita School of Arts and Sciences, Kochi.
Phone: 0484 - 2802899, 2801489, 2801965. Fax: 0484 - 2802511
E-mail ID: [email protected]
Checklist for Enclosures
U.G. programmes
Integrated programme
[B.C.A., B.Com., B.B.M., B.Sc. (VM)]
5 year Integrated M.A. (English Language and
Literature)
Photocopies (Self - Attested) of
Photocopies (Self - Attested) of
1) S.S.L.C. or equivalent (10th )
1) S.S.L.C. or equivalent (10th)
2) H.S.E. or equivalent (12th)
2) H.S.E. or equivalent (12th)
3) Conduct Certificate
3) Conduct Certificate
P.G. programmes
[M.Com., M.F.A., M.J.M.C. and M.C.A.]
Photocopies (Self - Attested) of
1) S.S.L.C. or equivalent (10th)
2) H.S.E. or equivalent (12th)
3) Degree Marklis/ Grade sheets(all semesters
/ years) (*)
4) Conduct Certificate
5) Provisional Certificate (if available)
6) Degree Certificate (if available)
(*) If the Final (year / semester) examination results are pending, students may enclose photocopies of
Marklists / Grade sheets of the results published so far. However, the photocopies of the pending
Marklists / Grade sheets must be submitted to the Admission Office as early as possible by Hand
/ Speed Post / Registered Post / Courier alongwith a covering letter quoting your Name, Course
applied for and Application form number.