RANI DURGAVATI VISHWAVIDYALAYA, JABALPUR
    		   (Formerly, University of Jabalpur)
			    APPLICATION FORM                                       
    Application for Enrolment of the student in the university

To be got filled by the College     To be got filled by the Office
Name of the College:............  Enrolment Number:

Academic Session: ..............  Applicant deserve to be admitted to
	 			        the desired course. 
Course:........ Class: .........  I checked & verified his/her 
	   			        certificates.  He/She deposited the
                                  prescribed fee.
__________________________________________________________________

To,
	The Registrar,
	Rani Durgavati Vishwavidyalaya,Pachpedi, Jabalpur,M.P. INDIA.
Sir,
I request you, for the Enrolment of the student in Rani Durgavati 
Vishwavidyalaya, Jabalpur alongwith the prescribed fee and other 
necessary documents:

1.   Full Name (In English): ........................................

     (in Hindi): ....................................................

2.   Father's Name: .................................................

3.   Mother's Name: .................................................

4.   Husband's Name: ................................................

5.   Address: Permanent:.............................................

                        .............................................

	Local Address:  .............................................

6.   Name of the Guardian and address: ...............................

     ................................................................

7.   Residing period in M.P.: .............. Years

8.   Date of Birth: (According to H.S.S.C/Equivalent Certificate):

     ................in words.........................................

2.   Name of the Exam: .................. Year ....... Month ........
      
3.   Roll No.: ..............	4.  Regular/Private/Ex-student: ......

5.   Centre from which appeared: ....................................

6.   Result: Passed/Failed: .......  

7.   The prescribed fee of Rs:.....(in words) .......................
     is deposited to the University office/is being sent herewith  by 
     Postal Order/Challan/Receipt No. ....................

8.   Address for Correspondence (Block Capital Letters):

      .................................................................

      .................................................................


9.(i)Mother Tounge: .........Religion:......... Nationality:..........

 (ii)  Cast (SC/ST/Backward):.........................................

10.  Details of the Previous Exam Passed, based on which the applicant 
     is willing to take admission in this University:

______________________________________________________________________
Passed  Year/  Enrol. Board/      Instituation's  Subjects  Div  Total
Exam    Month  No.    University  Name, in which                 Marks
                                  studied                        & % 
______________________________________________________________________







______________________________________________________________________
11.  Name of the Course, in which  the candidate is willing to take
     the admission, please give the details:

     Exam: ................................ Subject choosen for the    
  course: ......................................................

12.  Date of Admission to College/U.T.D: ..........................

13.  If working in Govt./Private Organization, please give details:

     Place:.......... Designation:..........Office: ................

14.  If studied in any College/Uni., after passing the previous exam
     give details:
     College: ...................... University: ...................

     Examination: .................. Year: .........................

     I declare that the information given above are true in my 
knowledge and belief. 	 

   				Signature of the Candidate

                           CERTIFICATE

The statements are correct as per  my knowledge and belief.I checked 
and verified the certificates of the qualifying examination. The True 
copy of the Transfer Certificate from School/College and marksheets 
are enclosed herewith.  The qualifying examination passed by the 
candidate is recognized by this university.  Therefore the candidate 
is eligible to be admitted to the course applied for 

Date:				Signature of Principal/Head
                           College/University Teaching Department	
___________________________________________________________________
1.  Name of the candidate must be same as mentioned in the previous
    examination certificate.  The female candidates are required to
    mention Smt/Ku. as applicable.
2.  Submit the attested copy of the following alongwith	the appli-
    cation form:
    -Certificate of passed examination
    -Mark-sheet of Passed Examination
    -Transfer Certificate of College/University
    -Original copy of Migration Certificate of Board/University
    -Character Certificate from two persons (only applicable to
     candidates, those not studied in any School/College in their
     previous examination).
_________________________________________________________________
Note: 1.  Attestation of Certificate is acceptable done by from 
          the Principal of the related college.
      2.  Incomplete applications are not entertained by the
          university.
      3.  Except the student of M.P. Board of Higher Secondary/
          Rani Durgavati Vishwavidyalaya, all other students are 
          required to submit the original copy of their 
          migration certificate.