GAUHATI UNIVERSITY

M.B.A (Industry Integrated) Third/Fourth Semester Examination, 20 Specialization 1:__________________ Specialization 2:____________________ APPLICATION To, The Controller of Examinations, Gauhati University, Guwahati 14 Sir, I request permission to present myself at the ensuing .......... Semester MBA (II) Examination to be held in the month of 20.. The Examination fee of Rupees .. is forwarded herewith. If any of the statements made in the application be found to be not true, or if it appears that in the opinion of the University rules and regulations relating to the MBA (II) Examination, my admission to the Examination will be liable to be cancelled by the University, at any time. Yours obediently, Name (in full): .. Present Address: ... Date .. 20 G.U. Registration/Roll No Year .. CERTIFICATE I certify that the above named candidates has fulfilled all the requirements under the regulations to be eligible to appear at the above Semester Examination course and that he/she attended the minimum number of lectures required in the different subjects and that I know nothing against his/her moral character

Principal ... College Date .. 20.

PARTICULARS TO BE FILLED IN BY THE CANDIDATE 1. 2. 3. 4. 5. 6. 7. 8. 9. Name in full (in Block letters): Miss/Mr./Mrs. ... G.U. Registration No./Roll No and Year: of .. Home Address in full: . Fathers/Guardian Name: Mothers Name: .. Nationality: Date of Admission to Course .. Age: (a) Particulars of passing the BA /B.Sc/B.Com/B.Tech (Final Examination) (Attested M/S must be enclosed) Year . Roll No. .. Class. University . Branch (b) Particulars of passing the MBA First Semester Examination. Year . Roll No. .. Subject.. (C) Particulars of passing the MBA Second Semester Examination. Year . Roll No. .. Subject.. (d) Particulars of passing the MBA Third Semester Examination. Year . Roll No. .. Subject.. (e) Particulars of passing the MBA Fourth Semester Examination. Year . Roll No. .. Subject.. 10. Last Examination appeared Year Roll No. 11. Examination appearing (State clearly the branch and part) 12. Course and subjects in which appearing course..Semester Specialization 1... Specialization 2. Subject: 1 .. 5. . Code 2 ...... 6. .. & Name 3. ... 7. .. 4. ... 8. .. 9. .. 10 13. If appearing under compartmental Rules: (State Roll No. and Year of Original Examination and Subject appearing) Roll No. . Year .. Subject. 14. If expelled and debarred from appearing at any University Examination state. Examination . Roll No Year Checked and Countersigned Principal of College (Signature of the Applicant)

Date 20.. Particulars to be filled in by the Principal of the College Date of Date of Institution in No. of P.C. of Collegiate Admission Completion of which the Lecture Lectures in____Sem the____Sem. candidate Delivered/ attended Course Course has studied Attended

Non Collegiate

Remarks

Date 20..

Signature of the Principal College Seal