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HASSAN UNIVERSITY
HEMAGANGOTHRI
2023-24£Éà ¸Á°£À ¸ÁßvÀPÆ
É ÃvÀÛgÀ ¥Àz«
À /¸ÁßvÀPÉÆÃvÀÛgÀ r¥ÉÆèêÀiÁ PÉÆùðUÉ ¥ÀæªÉñÀ Cfð
APPLICATION FORM FOR ADMISSION TO POST GRADUATE DEGREE/PG
DIPLOMA COURSES 2023-24
¸ÀÆZÀ£É : 1. CfðzÁgÀgÀÄ CfðAiÀÄ£ÀÄß ¨sw À ð ªÀiÁqÀĪÀ ªÉÆzÀ®Ä ¥ÀæªÃÉ ±Áw ¤AiÀĪÀÄUÀ¼À£ÀÄß ZÉ£ÁßV
Applicant
CxÀðªÀiÁrPÉƼÀî¨ÉÃPÀÄ. Recent
2. J¯Áè C¨sÀåyðUÀ¼£À ÀÄß ¸ÁªÀiÁ£Àå ¥ÀæªÃÉ ±À( ¹ÌÃA ‘J’ ªÀÄvÀÄÛ ‘©’ CrAiÀÄ°è) ¥ÀjUÀt¸À¯ÁUÀĪÀÅzÀÄ. Photo

Note: 1. Applicants are required understand the rules of admission instructions to candidates
before filling up the application.
2. All applicants will be considered for admission under Scheme 'A' and Scheme 'B'.
1. C¨sÀåyðAiÀÄ ºÉ¸ÀgÀÄ ( zÀ¥Àà CPÀëgÀUÀ¼À°è)
Name of the Applicant (in Block Letters)
2. vÀAzÉ/ vÁ¬Ä/¥ÉÆõÀPÀgÀ ºÉ¸ÀgÀÄ
Name of the Father/Mother/Guardian

3. (C) ºÀÄnÖzÀ ¸ÀܼÀ (a) Place of Birth

ºÀ½î/ ¥ÀlÖt vÁ®ÆèPÀÄ f¯Éè gÁdå
Village/Town Taluk District State

(D) ºÀÄnÖzÀ ¢£ÁAPÀ (J¸ï.J¸ï.J¯ï.¹. CxÀªÁ vÀvÀìªÀiÁ£À ¥ÀjÃPÉë CAPÀ¥ÀnÖAiÀÄ ¥ÀPæ ÁgÀ)
(b) Date of Birth (as in the S.S.L.C. marks card or its equivalent)
¢£À wAUÀ¼ÀÄ ªÀµÀð
Day Month Year

4. CºÀðvÁ ¥ÀjÃPÉA ë iÀÄ°è CzsÀåAiÀÄ£À ªÀiÁrzÀ LaÑPÀ «µÀAiÀÄUÀ¼ÀÄ, ¨sÁµÉUÀ¼ÀÄ, ¥Àæw «µÀAiÀÄzÀ°è ¥ÀqÉzÀ CAPÀUÀ¼ÀÄ (ªÀÄÆgÀÄ ªÀµÀðUÀ¼À CAPÀ
¥ÀnÖUÀ¼À ¸ÀéAiÀÄA ¥ÀæªÀiÁtÂvÀ ¥ÀæwUÀ¼À£ÀÄß ®UÀwÛ¸À¨ÉÃPÀÄ. CAPÀUÀ¼ÀÄ UÉæÃqï£À°èzÀÝgÉ ¥ÀjªÀvÀð£À ¥ÀnÖAiÀÄ£ÀÄß ¸ÀºÀ ®UÀwÛ¸À¨ÉÃPÀ Ä.)
Optional Subject and languages studied at the qualifying examination and marks obtained in each subject
(enclose self-attested copies of marks cards of all the three years. In case marks are in grades then copy of
the conversion table should also attached)
Optional I Year II Year III Year Total
III Sem Obtained

IV Sem Obtained

VI Sem Obtained
II Sem Obtained

V Sem Obtained
I Sem Obtained

III Sem Max

IV Sem Max

VI Sem Max
II Sem Max

V Sem Max
I Sem Max
Marks

Marks

Marks

Marks

Marks

Marks

Marks

Marks

Marks

Marks

Marks

Marks

Grand Total
Language
I

Language
II

1
5. ªÉÊAiÀÄQÛPÀ «ªÀgÀUÀ¼ÀÄ Personal Particulars:
gÁ¶ÖçÃAiÀÄvÉ eÁw °AUÀ ªÀiÁvÀÈ ¨sÁµÉ
Nationality Caste Gender Mother Tongue

6.
AiÀiÁªÀ PÉÆùðUÉ ¥ÀæªÃÉ ±À PÉÆÃjzÉ: PÉÆøïð:
Course to which admission is sought:

«.« PÁåA¥À¸ïÀ/ ¸ÀAAiÉÆÃfvÀ PÁ¯ÉÃf£À°è PÉÆøÀð£ÀÄß

¥ÀqA
É iÀÄ®Ä EaѸÀÄwÛgÀ: University Campus/ Affiliated College :
Course in University Campus/ Affiliated
College
7.
r.r ¸ÀASÉå ªÀÄvÀÄÛ ¢£ÁAPÀ :
±ÀÄ®Ì vÀÄA©zÀ «ªÀgÀ / Fee Paid
ªÉÆvÀÛ :
(zÀAiÀÄ«lÄÖ r.r AiÀÄ£ÀÄß CfðAiÉÆA¢UÉ ®UÀwÛ¹)(Please enclose Demand Draft
with application)

8. PɼV À Ö ZËPÀnÖ£À°è“✔UÀÄgÀÄw¹. ¤ÃªÀÅ AiÀiÁªÀ ªÀUð

À £À AiÀiÁªÀ UÀÄA¦£À°è ¥ÀæªÃÉ ±À PÉÆÃgÀÄwÛÃj. ¸ÀA§AzsÀ¥l À PÉÌ ¸ÉÃjgÀÄ«j:
Under which category seat is claimed? Please Mark “✔” in the concerned Box. Mention here the caste to which
you belong:

¥Àj²µÀÖ eÁw ¥Àj²µÀÖ ¥ÀAUÀqÀ ªÀUÀð 1 ªÀUÀð 2 J ªÀUÀð 2© ªÀUÀð 3 J ªÀUÀð ©

SC ST Cat.-I Cat.- II A Cat.- II B Cat.- III A Cat.- III B
ºÉÆgÀ «.« ¤®AiÀÄ gÀPÀu
ë Á zÀ¼À /ªÀiÁf AiÉÆÃzsÀgÀÄ CAUÀ«PÀ®gÀÄ PÀ£ÀßqÀ ªÀiÁzsÀåªÀÄ
Other University Defence/Ex –Servicemen Physically Challenged Kannada Medium
¤AiÉÆÃfvÀgÀÄ «zÉò ¥ËgÀ C¤ªÁ¹ ¨sÁgÀwÃAiÀÄgÀÄ ªÀ®¸É §AzÀ PÁ²äÃjUÉ
Deputation Foreigner N.R.I Kashmiri Migrant

¸ÀÆZÀ£É: ¸ÀA§AzsÀ¥ÀlÖ C¢üPÁjUÀ½AzÀ ¥Àq¢

É gÀĪÀ ¥ÀæªÀiÁt ¥ÀvU
Àæ À¼À£ÀÄß ®UÀw¸
Û À¢zÀÝgÉ D UÀÄA¦£À°è CfðAiÀÄ£ÀÄß ¥ÀjUÀt¸ÀĪÀÅ¢®è.
Note: Certificates from the Competent Authority shall be attached, failing which the application will not be considered
under that category.

9. 1. vÉÃUÀðqÉAiÀiÁVgÀĪÀ ¥Àz«
À DºÀðvÁ ¥ÀjÃPÉë
Degree/Qualifying Examination passed:

2. DºÀðvÁ ¥ÀjÃPÉA
ë iÀÄ°è ¥Àqz
É À ±ÉÃPÀqÀ CAPÀUÀ¼ÀÄ
Percentage of marks secured in the Qualifying Examination
10. »AzÉ ªÁå¸ÀAUÀ ªÀiÁrzÀ ¸ÀA¸ÉÜ ªÀÄvÀÄÛ «±Àé«zÁ央AiÀÄ
Institution and University last attended

¸ÀA¸ÉÜ: ¸ÉÃjzÀ ¢£ÁAPÀ:

Institution Date of Admission

«±Àé«zÁ央AiÀÄ: ¥Àz«
À ªÀÄÄV¹zÀ ¢£ÁAPÀ:
University Date of Completion of Degree:

11. vÀAzÉ / vÁ¬Ä/ ¥ÉÆõÀPÀgÀ ºÉ¸ÀgÀÄ, GzÉÆåÃUÀ ªÀÄvÀÄÛ PÀÄlÄA§zÀ ªÁ¶ðPÀ DzÁAiÀÄ.
Name, Occupation and total Annual Income of Parents/Guardian (if parents not alive)

ºÉ¸ÀgÀÄ (vÀAzÉ/vÁ¬Ä/¥ÉÆõÀPÀgÀÄ) GzÉÆåÃUÀ ªÁ¶ðPÀ DzÁAiÀÄ

Name (Father/Mother/Guardian) Occupation Annual Income

2
12. (C) SÁAiÀÄA «¼Á¸À, ªÉƨÉÊ¯ï ¸ÀASÉå ºÁUÀÆ E-ªÉÄïï LrAiÉÆA¢UÉ (D) ¥ÀvÀæ ªÀåªÀºÁgÀPÁÌV «¼Á¸À:
(a) Permanent Residential Address with cell no and e-mail id (b) Postal Address:

Mob No :
E-Mail ID :

13. »A¢£À ªÀµÀðUÀ¼À°è PÀ£ÁðlPÀ gÁdå/ ¨sÁgÀvÀzÀ AiÀiÁªÀÅzÉà CAVÃPÀÈvÀ «±Àé«zÁ央AiÀÄzÀ°è AiÀiÁªÀÅzÁzÀgÀÆ ¸ÁßvÀPÉÆÃvÀgÛ À ¥ÀzÀ« ªÁå¸ÀAUÀ
ªÀiÁr¢ÝgÀ?. ªÀiÁrzÀÝ°è «ªÀgÀUÀ¼À£ÀÄß ¤Ãr.
Have you pursued a Master's Degree Course in the any other recognised University in Karnataka/ India in any subject during the
previous years? If yes, furnish details.
«±Àé«zÁ央AiÀÄ ªÁå¸ÀAUÀ ªÀiÁrzÀ PÉÆøï ð ªÀµÀð MlÄÖ CAPÀUÀ¼ÀÄ ¥Àqz
É À CAPÀUÀ¼ÀÄ ±ÉÃPÀqÀ
University Course Studied Year Total Marks Marks Obtained Percentage

14. ¨ÉÃgÉ PÉÆøïðUÀ½UÉ ¤ÃªÀÅ ¥ÀæªÃÉ ±ÀPÉÌ Cfð ¸À°è¹zÀÝgÉ CªÀÅUÀ¼À «ªÀgÀ: 1.
If you have applied for other Course, give details:

2.

3.

4.

WÉÆõÀuÉ

1. £Á£ÀÄ ¸ÁßvÀPÉÆÃvÀg Û À ¥ÀzÀ« /¸ÁßvÀPÉÆÃvÀgÛ À r¥ÉÆèêÀiÁ PÉÆùð£À ¥ÀæªÉñÁwUÁV F Cfð ¸À°è¸ÀÄwÛzÉÝÃ£É F ¸ÀA§AzsÀ ¥ÀæªÉñÁw ¤AiÀĪÀiÁªÀ½UÀ¼À£ÀÄß
N¢PÉÆArzÉÝãÉAzÀÄ WÉÆö¸ÀÄvÉÃÛ £É.
2. ªÉÄÃ¯É ¤ÃrzÀ ºÉýPÉ ªÀÄvÀÄÛ £À£Àß Cfð ºÁUÀÆ CzÀPÉÌ ®UÀw¹ Û gÀĪÀ zÁR¯ÉUÀ¼À°è MzÀV¹gÀĪÀ ªÀiÁ»wUÀ¼ÀÄ ¤dªÁVzÉ JAzÀÄ
¥ÀæªÀiÁt¥ÀƪÀðPÀªÁV ªÀÄvÀÄÛ ¸ÀvÀ夵ÀתÁV zÀÈrüÃPÀj¸ÀÄvÉÃÛ £É E°è MzÀV¹zÀ ªÀiÁ»wUÀ¼À°è «ªÀgÀUÀ¼ÀÄ ¸ÀļÁîVgÀĪÀÅzÀÄ PÀAqÀħAzÀgÉ, £Á£ÀÄ PÁ£ÀÆ£ÀÄ
PÀæªÀÄPÉÌ M¼ÀUÁUÀÄvÉÃÛ £É ªÀÄvÀÄÛ £À£ÀUÉ ¤ÃrgÀĪÀ ¥ÀæªÉñÀªÀ£ÀÄß gÀzÀÄÝ¥Àr¸À¯ÁUÀĪÀÅzÀÄ JA§ÄzÀ£ÀÄß £Á£ÀÄ CjwzÉÝãÉ

DECLARATION

1. I submit this application seeking admission Postgraduate Degree/ Postgraduate Diploma Course. I declare that I have read the
rules and regulations in this regard
2. I hereby solemnly and sincerely affirm that the statement made and information furnished in my application form and also in
the enclosures thereto submitted by me are true. Should it, however, be found that any information furnished herein is untrue
in material particulars, I realize that I am liable for criminal prosecution and the seat given to me shall be liable to be forfeited

Signature of Applicant

Date:

Place:

3
 C¨sÀåyðUÀ½UÉ ¸ÀÆZÀ£É
INSTRUCTIONS TO CANDIDATES

1. ¨sÀwð ªÀiÁrzÀ CfðUÀ¼À£ÀÄß s¸ÀAAiÉÆÃdPÀgÀÄ, ¸ÁßvÀPÉÆÃvÀg

Û À ¥ÀæªÉñÁw PÉÃAzÀæ, DqÀ½vÀ ¨sÀªÀ£À ºÁ¸À£À «±Àé«zÁå®AiÀÄ, ºÉêÀÄUÀAUÉÆÃwæ,
ºÁ¸À£À -573226 EªÀjUÉ RÄzÁÝV/CAZÉ ªÀÄÄSÁAvÀgÀ ¸À°è¸À¨ÉÃPÀÄ.
The application forms duly filled should be sent to the P.G Admission Coordinator, Administration Office,
Hassan University, Hemagangothri, Hassan-573226

2. «zÁåyðAiÀÄÄ MAzÀQÌAvÀ ºÉZÀÄÑ PÉÆùðUÉ Dfð ¸À°è¸À®Ä EaѹzÀ°è ¥ÀævÉåÃPÀ CfðAiÀÄ£ÀÄß ºÁUÀÆ ¤UÀ¢vÀ ±ÀÄ®Ì
¥ÁªÀw¹zÀ ZÀ®£ï, CAPÀ¥ÀnÖ ªÀÄvÀÄÛ eÁw/DzÁAiÀÄ ¥ÀæªÀiÁt ¥ÀvÀæzÀ ¥Àæw ¸À»vÀ ¸À°è¸ÀvÀPÀÌzÀÄÝ.
If the candidate is applying for more than one programmes, the Xerox copy of the original application along with
the copies of the challan, marks card and caste / Income certificate should be submitted to the P.G Admission
Centre.

3. ¸ÀévÀB ¥Àª
æ ÀiÁtÂÃPÀÈvÀ £ÀPÀ®ÄUÀ¼À£ÀÄß ªÀiÁvÀæ CfðUÉ ®UÀwÛ¸À¨ÉÃPÀÄ. ¥ÀæªÉñÀzÀ ªÉüÉAiÀÄ°è ªÀÄÆ® ¥ÀæªÀiÁt ¥ÀvÀæUÀ¼À£ÀÄß MzÀV¸À¨ÉÃPÀÄ.
Self-attested copies of the required certificate, marks cards should be attached to the application. Originals should
be produced at the time of admission.

4. ¥ÀæªÉñÁw ¸ÀªÀÄAiÀÄzÀ°è ºÁdgÀÄ¥Àr¸À¯ÁUÀĪÀ ªÀÄÆ® CAPÀ ¥ÀnÖUÀ¼ÀÄ ªÀÄvÀÄÛ ¥ÀæªÀiÁt ¥ÀvÀæUÀ¼À£ÀÄß D ²PÀt
ë zÀ CªÀ¢ü ªÀÄÄVAiÀÄĪÀªÀgÉUÀÆ
»AwgÀÄV¸À¯ÁUÀĪÀÅ¢®èªÉA§ÄzÀ£ÀÄß C¨sÀåyðUÀ¼ÀÄ UÀªÀĤ¸ÀvÀPÀÌzÀÄÝ,
Candidates seeking admission to a programme should note that their original marks card and other certificates
produced at the time of admission to the programme will not be returned until they complete the programme.

5. C¥ÀÇtð CxÀªÁ vÀ¥ÀÅà ªÀiÁ»wAiÀÄļÀî ªÀÄvÀÄÛ ¸À» ªÀiÁqÀzÉ EgÀĪÀ CfðAiÀÄ£ÀÄß wgÀ¸ÀÌj¸À¯ÁUÀĪÀÅzÀÄ.
Unsigned/incomplete/wrongly filled-in applications are liable to be rejected.

6. CºÀðvÁ ¥ÀjÃPÉAë iÀÄ CAwªÀÄ ¸É«Ä¸ÀÖgï ¥ÀjÃPÉU ë É ºÁdgÁzÀ C¨sÀåyðUÀ¼ÀÄ vÀªÀÄä ¥sÀ°vÁA±ÀUÀ½UÁV PÁAiÀÄzÉà Cfð ¸À°è¸À§ºÀÄzÀÄ.
ªÀÄÆ® CAPÀ¥ÀnÖUÀ¼À£ÀÄß ¥ÀæªÉñÁw ¸ÀªÀÄAiÀÄzÀ°è ºÁdgÀÄ¥Àr¸ÀĪÀÅzÀÄ.
Candidates who have appeared for the final semester examination of the qualifying degree can apply for P.G
Admission without waiting for their results. Original marks cards shall be submitted at the time of admissions (if
they are selected).

7. ¥ÀæªÃÉ ±ÁwUÉ ¸ÀA§A¢ü¹zÀ Cfð £ÀªÄÀ Æ£É, E-ªÀiÁ»w ¥ÀĹÛPÉ ªÀÄvÀÄÛ EvÀgÀ ªÀiÁ»wUÀ½UÁV F PɼV À £À zÀÆgÀªÁt ¸ÀASÉå
ºÁUÀÆ ªÉƨÉÊ¯ï £ÀA§gÀÄUÀ¼À£ÀÄß ¸ÀA¥ÀQð¹ ¥sÉÆãï.08172-220014, ªÉÆ.£ÀA. 9986859851, 9141419806, 8197050324
All the information related to PG Admissions, Application form & e-Prospectus is available at
Hassan University Contact Telephone No. 08172-220014, Mobile No. 998685985, 9141419806,
8197050324
8. ¥ÀæªÉñÁw ¥ÀæQæAiÉÄUÉ ¸ÀA§A¢ü¹zÀAvÉ J¯Áè «zÁåyðUÀ¼ÀÄ Cfð ±ÀÄ®Ì gÀÆ 500/- C£ÀÄß ¨ÁåAPï ZÀ®£ï/r.r ªÀÄÆ®PÀ ¥ÁªÀw¸ÀĪÀÅzÀÄ.
r. r AiÀÄ£ÀÄß ºÀtPÁ¸ÀÄ C¢üPÁjUÀ¼ÀÄ, ºÁ¸À£À «±Àé«zÁå®AiÀÄ, ºÁ¸À£À EªÀgÀ ºÉ¸Àj£À°è ¥ÁªÀw¸ÀvÀPÀÌzÀÄÝ.
The prescribed application processing fee Rs. 500/- for all candidates shall be paid through bank challan or DD
the same has to be submitted to the university. Demand Drafts shall be drawn in favor of the Finance Officer,
Hassan University, Hassan.

9. DAiÀiÁ «¨sÁUÀUÀ¼ÀÄ CºÀð «zÁåyðUÀ¼À CºÀðvÁ ¥ÀnÖAiÀÄ£ÀÄß ¥ÀzÀ« CAPÀUÀ¼ÀÄ ºÁUÀÆ «ÄøÀ¯ÁwAiÀÄ DzsÁgÀzÀ ªÉÄïÉ
vÀAiÀiÁj¸À¯ÁUÀĪÀÅzÀÄ.
Merit List of eligible candidates seeking admission to various programmes will be prepared by the P.G.
Admission Centre by considering the marks scored in Qualifying UG examination and roaster system.

PÀÄ®¸ÀaªÀgÀÄ
ºÁ¸À£À «±Àé«zÁå®AiÀÄ
ºÉêÀÄUÀAUÉÆÃwæ