REGULAR/REPEATERS/IMPROVEMENT

NAGALAND UNIVERSITY
(A Central University Estd. By the Act of Parliament No. 35 of 1989)
HEADQUARTERS: LUMAMI-798627

APPLICATION FORM FOR BA/B.Sc/B.Com/BCA/BBA I/II/III YEAR ANNUAL EXAMINATION

20_________

Particulars to be filled in by the Applicant

1. Official Name in Full (in BLOCK LETTERS) : _______________________________________

2. Fathers Name /Mother’s Name : _______________________________________

3. University Roll Number : _______________________________________

4. Registration Number : _______________________________________

5. Nationality : _______________________________________

6. Sex: _____________ Category : _______________________________________

7. College : _______________________________________

8. Subject and Papers to be examined

Indicate No of
attempt against each
Sl. Paper Course
Subject Title of the paper paper
No. No. No.
(Eg. Regular, 1st rep.,
2nd rep/ improvement)
1
2
3
4
5
6
7
8
9

(For Practical at back page)

Date: ...................................... (Signature of the Applicant)

Certified that the statement furnished by the applicant are verified and found correct. The applicant is
eligible to appear ______________ Examination.

Date: ...................................... (Signature & Seal of the Principal)

Page 1 of 2
FOR PRACTICAL

Sl. Paper Course

Subject Title of the paper
No. No. No.
1
2
3
4
5
6
7
8
9
10

Date: ________________ ___________________________________

Signature of the Principal with Office Seal

Page 2 of 2