Application Form Fees Deposit Receipt 2018

Study Centre & Programme Details

PROGRAMME* SESSION
*SE-DE Represent Programme being Run By Department of Special Education, MPBOU and Approved by RCI  
SPECIALIZATION* ELIGIBLITY*
FIRST STUDY CENTRE* SECOND STUDY CENTRE*
THIRD STUDY CENTRE* MEDIUM*
# Study Centre Approval pending from RCI/MPBOU
(If any centre becomes non functional due to any reasons, on that case all students will be transfer to second choice study centre.)  

Personal Details

FIRST NAME* LAST NAME*
FATHER'S NAME* MOTHER'S NAME
GENDER*   CATEGORY
DOB (DD/MM/YYYY) *  SUB CATEGORY
NATIONALITY *
RELIGION * MARITAL STATUS

Address

Correspondance
Permanent
Copy to Permanent Address

Other Details

Phone Number(With STD Code) Mobile Number*
Email Id Fax No.
Photo Id* Photo ID No.*

Educational Qualification

Examination
Institute/University
Year of Passing
% of Marks
Division
Marksheet No

Other Qualification

Examination Institute/University Year of Passing % of Marks Division Marksheet No

Employment Details (IF You are Working)

Name of Institute with Address   Working From     - To    Designation 

Special criteria/qualification

Certificate No  

Enclosures

MARKSHEET[GRADUATION]
CASTE CERTIFICATE
HANDICAPPED CERTIFICATE
2 PASSPORT SIZE PHOTO(COLOR)
TEACHING EXPERIENCE CERTIFICATE

Fees Details

Form Fee Portal Fee Late Fee Total Fee
0
DECLARATION
 I HEREBY DECLARE THAT I HAVE READ AND UNDERSTOOD THE CONDITION OF ELIGIBILITY FOR THE PROGRAMME FOR WHICH I SEEK ADMISSION.I FULFILL THE MINIMUM ELIGIBILITY CRITERIA AND HAVE PROVIDED NECESSARY INFORMATION IN THIS REGARD.IN THE EVENT OF ANY INFORMATION BEING FOUND INCORRECT OR MISLEADING,MY CANDIDATURE SHALL BE LIABLE TO CANCELLATION BY THE UNIVERSITY AT ANY TIME AND I SHALL NOT BE ENTITLED TO REFUND OF ANY FEE PAID BY ME TO THE UNIVERSITY.
Aadhar No. Declaration *
I here by declare that With my consent, I am giving this base number to university.