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Cacee Application 1 2

This document is an application form for continuing education courses at the University of Kerala. It collects personal information such as name, age, marital status, economic status, educational background, and course fee details. The form also includes a declaration section for the applicant to confirm the accuracy of the provided information.

Uploaded by

Nikita Diwan
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© © All Rights Reserved
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Download as PDF, TXT or read online on Scribd
12 views

Cacee Application 1 2

This document is an application form for continuing education courses at the University of Kerala. It collects personal information such as name, age, marital status, economic status, educational background, and course fee details. The form also includes a declaration section for the applicant to confirm the accuracy of the provided information.

Uploaded by

Nikita Diwan
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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UNIVERSITY OF KERALA Photo

CENTRE FOR ADULT, CONTINUING EDUCATION AND EXTENSION


VIKAS BHAVAN P.O, PMG JN., THIRUVANANTHAPURAM – 695033

APPLICATION FORM FOR CONTINUING EDUCATION COURSES

NAME OF COURSE ………………………………………………………………………

1. a) Name in English ( in block letters ) :


b) Name (in Mother Tongue) :
2. Sex : Male / Female

3. Age & Date of Birth :


4. Name of Father/Guardian :
(Specify Relation) : Mother / Father / Relative

5. Marital Status : Married / Un married

6. Economic Status : BPL / APL

7. Religion and Community :

8. Address for communication :

Pin
Email. id

9. Phone No.(with STD Code)


.
:
Mob No. :
10. Educational level :
Name of Institution Name of the course Year of Year of Subject Marks
Studied study passing the in %.
examination

11. Details of course fee


Sl. Date Name of Bank & Branch D.D.No. Amount
No.

DECLARATION
I …………………………………………………………….. do hereby declare that the
statements made in the application are true and the documents attached herewith are true
copies of the originals in my possession, which will be produced for verification when
required.

Place :
Date : Signature of applicant

OFFICE USE
Admitted / Not admitted

Date : Director

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