DR.C.V.

RAMAN UNIVERSITY
T PdSNandiwa AN AISECT GROUP UNIVERSITY

Form Numbe:
APPLICATION FORM
INSTRUCTIONS
Please read the instructions in the Information Brochure before filing up this form.
Use Block Letters to fill the Boxes English capltal letters or English numbers.
Do not make any stray marks on this sheet.
Do not staple, pin, wrinkle, scribble, tear, wet or fold this sheet.
5 Write in CAPITAL LETTERS only within the box without touching the lines as shown in the Sample below.

1213 4 5 67 B9ABICIDEFGHTJK|LMNOPOR SIT|UVWXYZ

1. Name of the Candidate (as in high school or equivalent certificate/marksheet)

INAY SINGH
2. Father's Name (as in high school or equivalent certificate/marksheet)
CHA ND |E|L IL ILU|
NAPA|SINGH CHAND EL
3. Mother's Name (as in high school or equivalent certificate/marksheet)
H|
KAmA SING HCAAN DELIL
4. Gender 5. Category 6. Date of Birth
LL
ta Femate CEN seST0c Dae3]Monm Ye9g
7. Course Appling For Semester Applied foor Specialization

Academic Session

(Refer Infonnation Brochure lor program name)

9. Aadhar Curd No: 4 6 o l a 7 5 4 6 5 2 2 10. Samagra id:

11. Nationaliy Indian Others L fothers (Pls. specily).... ---..

12. Place of Residence Rural Urban Domicile of M.P. Yes No

|13. Religio Hindu Sikh Islam Christian Others
others (PIS. specity)...*******1
14. Have you appeared for any State Level / National Level /University Level Exam
AJEE JEE. MBA CAT MAT Oher Score Percentage

15. Contact Numbers Students Mobile Number

Parents Mobile Number

|16. Mandaiory E-mail Address

Accom:dation Required Yes No Transporlation Required Yes No

17-Writeyour complete Permanent Correspondence address 18.Write your Complete Local address including your name in
including your name in English in Capital Letlers with English in Capital Letters.
Black Pen (for all cuonnunicalion including lelter of Adnission) (for all communication including letter of Admission)

Na une INAY SINGH CHA NDEL Nane

/TNAY SINGH CHANDEL
AtrassIANAHRD No. 04, NERR CIRWI
Ho USE, FRONT 0f MADAN
Aduress
LfRD No.0U MEAR CIRCUT
OUSE, FRDNT 0 MADAN
A1 ENG Y, SOHA% POR
AC1ENCY, SOHAoPO R_
Cily
SHAHDOOL Slate
M.P Ciy SHAHDOL State MP
Pin:4 4 o o Pin: R Holol1

1
 GUIDELTINES & NORMS/RULES FOR ADMISSION

. The applicants should read carefully the contents of the Information Brochure and familiarize themselves with the
relevant rules governing the Admission/Entrance Test/GD/ Interview of DR. C.V. RAMAN UNIVERSITY. They
should also check all the eligibility criteria for a particular programme.

2 DR. CV. RAMAN UNIVERSITY will not be responsible if a candidate is denied admission for not fulfiling the
eligibility criteria even if he/she has cleared the Entrance TestGD Interview and has been issued an Offer
Letter for admission to a particular programme ofstudy

3. Bachelor's degree signifies that the degree has been obtained under 10+2+3 system of education or its
equivalent.Application Form of candidate whose qualifying examination is not recognized by this University shall
not be considered for admission.

A. All admissions shall be provisional. f any omission/error in the processing/verification of certificates/documents

of a candidate or not fufilling eligibility criteria, etc., is detected at the time of admissions or thereafter, the
University shall have the right to cancel such admission at any time.

The University takes no responsibility for any delay in postal transit or non-receipt of Admit Card/ Interview Letter!
intimation Letter, etc., or any other communication related to admission as per regulations.

If it is discovered at any stage that a candidate has made a false representation or used fraudulent means for
admission or that he/she does not fulfil the eligibility requirements, he/she will not be allowed to complete
admission formalities. If admission has been granted to such candidate, the same shall be liable to be cancelled
at any stage. The University reserves the right to ask the candidate to reappear in the Entrance Test to assess his
candidature if considered necessary.

Candidales getting Supplementary/Compartmen/Essential Repeat in the qualiífying examination are not entitled
to get admission. Final result must be submited by 31" August in any case, after which admission will
automatically getcancelled.

8. No candidate is allowed to pursue two regular courses simultaneously in one academic year.

he list of selected candidates will be displayed on the University Notice Board and University website
www.cvrump.ac.in.It is the responsibility of the candidate to keep himself/ herselfinformed aboul such notices.
The University shall not be responsible if a candidate fails to get information regarding his/her selection for
admission.

10 A candidate not reporüing for admission on the date and time as stipulated, shall forfeit his/her claim for admission
and no further correspondence in this regard will be entertained.

11 Candidates not selected for admission shall not be infomed. In the event of non-selection, his/her Application
Form/Fees/ Photo copies of the attached Certificates/Documents shall not be returned.

12 Acandidate already enrolled in any programme of DR. C.V. RAMAN UNIVERSITY will be required to get his/her
admission cancelled from the programme he/she is pursuing in this University to be eligible for admission to
anotherprogramme
13. The applicant is required to fill in the Application Form by himself / herselfwith correct information.

14 tn case of withdrawal of admission, the candidate will not be

eligible to get any refund from the University
 itavarsyFrre WAr Suayects Marks

M R60AD 2012 P G6
2015 622

Ainatie a t h E xPiTASC ,te)

uificti PrtAesi Organisafion Oesigratin

are1t:

HHHHHHHHHH
A

t h FRerceigt No

De with U) No
Date

Peceipt No

rat antownaton given in the Applcaluon (all relevant Foms) s comie'e and accusate I undersland and agree Ihal missepresentaions or
ty the 0eniai of admssion the cancelation otadms sion of eapulsion

lerms & Conaitons for Aamission

sent
to the asmentaned the intormation Brochure
r

in

Date

Declaration
I herety declare that the information submitted is complete and correct to the best of my
kDWie 3ge. I fully agree to abide by the rules and regulations of the University as they are
ar rmay be constituted in the future and will not claim for any refund of fees.

Signature of Applicant

afte sted nark sheets

14 Candles are required to produce the original mark sheets/certificate of qualifying examination and other necessary
cdocumonts at the time of reporting for admission, while completing the admisslon formalities. The candidates who have
applie as'result awaited' should verify original copy and submit altested copies of their mark sheets within ten days of the
daclar. on of results but not after the date of closure of admission of DR. C.V. RAMAN UNIVERSITY. Form No. and Roll No.
allotte by DR. C.V. RAMAN UNIVERSITY should be written clearly on the back of the mark sheet, falling which the offer of
dmisn shall be cancelled and no further in the matter shall be
correspondence entertained. Original documents are
requi efor Admission.

15 Applicoion Fom shall be liable to be rejected in case:

Ap ication Forms received after the last date
Those received without requisite fee
Paing of the requisite fee through Demand Draft with lesser amount
Dmand Drat of requisite fee not drawn in favor of DR.C.v.RAMAN UNIVERSITY, payable at Khandwa.
In omplete information
Mulated fom
No tu ther corespondence shall be entertained in this rogard. Applicantis advised to ensure that his/her Online
Application Form is correctly filled)

16 The cenfidential marks, received directly on or before the last date for receiving the mark sheet under sealed cover in the name
of
of Examinations & Admissions, from the Universities/Boards where the
the Controler DR.CV.RAMAN UNIVERSITY
result of qualifying examination could not be declared fomally may be accepted, after obtaining the approval by the
Competent Authority of DR. C.V. RAMAN UNIVERSITY. Such a candidate must submit an under taking duly Notarized by a
publi:"lotarytothe effect that the Original Mark Sheet/Grade Sheet of the qualifying examination shall be submitted within the
stipula ed time limit.

1 any erepancy is found inthe examination result of the aforesaid candidate or the original Mark Sheet/Grade Sheet is not
produ ed within the stipulated time, the provisional admission so granted shall be cancelled.
18 No candidate shall be allowed to take admission to the same
Course/Class which he/she has already passed.
19. The application form can be filled online. However, in such cases a Print out of the form with photograph along with the fees
(through DD) should be sent to the Registrar of the Admission Section, DR. C.V. RAMAN UNIVERSITY, Khandwa. Printout
of the Application Form can be sent by Registered Post/Speed Post or through Courier so as to reach on or before the last date.
Printoui of the Forms received late, incomplete, without requisite fee, or not supported with the required certificates/ documents
shall be rejected and no further correspondence shall be entertained in this regard.
20 The candidates once admitted shall be governed by the rules and bye-laws of DR. C.V. RAMAN UNIVERSITY.
21 Ragging is strictly prohibited. Offenders will be dealtwith prescribed laws.

22 All mallers of dispute shall be subject to Khandwa jurisdiction only.

Signature

Da .....
Name of Student . . ********'"""**************

Undertaking by student
1 Ihave understood all the guideline & norms for admission given above and will abide by them.
2 will atlend all the classes in every semester from the opening day of the college as per timetable and secure attendance not
less tnan 75% in each class. I know that I
may be debarred from appearing in exam for short attendance or non-payment offees
on fime.
3. I will
compulsory follow the dress code and uniform prescribed by the university and conduct myself in a highly disciplined and
decent manner both inside the classroom and in the
campus, falling which suitable action may be taken against me as per the
rules and regulation
of the university.
will not bring Mobile Phone to the
Campus and also, I will not indulge in any form of ragging inside or outside the campus. Iam
fully avware that ragging in a grave offence and punishable as
will pay tuition fees, examination fee and
peruniversity rule/law.
any other dues within the stipulated time as required by the institute authonties,
failing which I will not be permitted to attend the classes and exam without payment of late fees as per rule.
. I shall check notice board and university website
regularly for information about examination, events, fees payment, dates
etc., and the university is not responsible to informme individually.
i will not claim any refund of fees if lwithdraw
my admission.
4
 DR.C.V. RAMAN UNIVERSITY
dekhandwa AN AISECT GROUP UNIVERSITY
Student Fee Record- 2021-2022
Name ******°******'*************
* ***
Course: ****
* * .Contact No..
***** . *********************************************************************
Year Tuition Bus Hostel Other Remark
1s
2
3
4th
5h
* ********
Admission Co-ordinator Approved By
Student Record Check List
Original Photo Copy Original Photo Copy
10h Marksheet .12hMark sheet
Graduation Marksheet Income Certificate (Latest)
Caste Certificate Domicile Certificate
TC
Aadhar Card
Migration Graduation Marksheet
Poly. Diploma Marksheet Bank Account No.
Blood Group (Please nmention-Compulsory)
Samgrald No.
 DR.C.V.RAMAN UNIVERSITY
ayadosh Khendwa AN AISECT GROUP UNIVERSITY

ENROLMENT&ELIGIBILITY FORM
To.
The Regisirar,
Dr. C.V. Raman University, Khandwa,

Sir,
vou
tu please accept my enroliment in DR. CV.
II request RAMAN
have atiached all the relevant documents. read and accepted the UNIVERSITY.
rules/regulations/ordinances
Khandwa and ofprovide me theEnrollment
the university number.Please
and promise to ablde by them. that
noteI as0
promise to otey all the rules and regulations enforced by the University/Govt. inthefuture.
Part- 1
(Write in CAPITAL LETTERS)

a) Name Mr./Mrs./Ms.
(as per 10+2 mark sheet passing certificate)
VINAY SINGH
CHN D EL
* * * * ' * ' * * * * ' * * * * * * * * * *

(b Name ofStudent in Hindi

Pasry
2. Date ofAdmission:

3. Name of the Board/ University & Last Qualify Exam:

Detail is given below:

Name of last University/Board Name % Marks Percentagel
Pass out Exam Passing Year

4. Name of the course Branch:

for admission:

5. Migration from other University: Yes| No Attach original migration certificateif yes)

Part
Certificate by HOD
Certified that the above student has been admitted to this department through procedure as laid down by the DR. C.V. RAMAN UNIVERSITY/
Govt. of Madhya Pradesh and the entries above have been checked and verified
be by me from the records. I, therefore recommend
that he/l she may
Eligible/ Enrolled in the University.

Signature of the AR Admission. Signature of the HOD

Name.. ** ** '*******'****'***** *'**"'' Name *****'*******
****** ***** **
' ' * * '**'****:
Department of . '******* *'*''* ** ' **'
** * * *
'***' ****'* '** * * * *
**
Department of ********* * * **.

Part l l
Enroliment by DR. C.V. RAMAN UNIVERSITY
Allotted Enrollment No
Data Operator. .. '

Checked by
Registrar
 RD DR. c.V. RAMAN UNIVERSITY
dlhvz. RrideshkancwaAN AISECT GROUPUNIVERSITY
EXAMINATION FORM
Instructions:
I. This Examination form should be filled by the candidate in his/her own
handwriting.
Use Capital Letters in Boxes.
I f application is not on prescribed form or incomplete, it will be rejected.
4. Separate examination form should be filled up for each Semester/ Exam.
S.Use separate application form for each semester Examination.

Regula Ex
SEMESTER COURSE BRANCH NAME BRANCH CODE

ENROLLMENT NO.
LU

NAME OF DEGREE

Name of Examinee (Name in English, should be as per mark-sheet of qualifying exam)

SURNAME:

NAME
C A N DEL L L II U
IN HINDI:
VINAYSLNGHLI
***********

FATHER'S
ta7rEg T
NAME:NI RP AT S N|G|H C HAN_D E
ADDRESS:
MOTHERSNAME K A MC[A STNGH CHAN D E |L-
Mobile No/Tel.: AADN.D SHA H DOU
Mention Subjects (TIheory & Practical) in which appearing with Code No.

Appearing in .Semester/Year: All Theory/Practical/Sessional

Theory Practical
SN Subjeet Code Title of the Subject SN Subject Code Title of the Subject

8
 S i LR. C.V. RAMAN UNIVERSITY
epcwaAN AISECT GROUP UNIVERSITY
CANDIDATE'S DIECLARATION:
that this me
certily enamination form has been filled by andthe information given therein is correct and
for the on.
same
I shall be personally
responsible if proved false later
a l s o certily th I am appearing as a candidate, only in the examination being conducted by
Dr.C.V.Raman University Khandwa (M.P.)
. Ifurther declare that l am neithera regular student of any other Education Institution nor appearing in any
other Examination as regular candidate.
understand that il it is found later on that the information furnished above is false then my result of
examination will be cancelled.
.assure you that I will complete the requirement of attendance and sessional work prescribed for the
course of my rgistration. Kindly permit me to appear in the examination to be held in
....I accept to abide by all the rules and regulations of study
(sem.)..... ******* **"
2nd cxamination a* prescribed by the Dept./institution and Dr.C.V.Raman University Khandwa (M.P.))
6. have read the relevant ordinance applicable to be and have completed all
the requirements as given in it.
T have completed my studies and have no objection in appearing in examination on the date declared by

the University.
* * * ° * * * ° * * * * *

Place:. Candidate's Signature

Date:

Full Name..

(To be certified by the Faculty Head)

CERTIFIED THAT
examined and verified properly and found correct. The
. The entries in the examination form have been
candidate is cligible to appear in the examination as per relevant ordinance and rules of Dr.C.V.Raman

University Khandwa (M.|'.).

2. The candidate had leposied the requisite fees.
from appearing to the above examination. (Due to rustication,
3. The aforesaid candidate is not debarred as per
illness etc.) and has completed the academic requirement
expulsion, attendance, practical's,
ordinance of the University.
the academic requirement up to the time of exam his
4. If due to any reason the student does not complete
and the candidate will be debarred from appearing in
admission card wil! be returned to the University
the examination.

Signature of Faculty
Signature of verilying oflicer with Namne
With date

Authorization to office
Note: The form should b signed by the Head of the Faculty only.
Staff or putting sinaturc seal is not allowed.