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Home , Kariavattom, Nangiarkulangara, Poojappura, University of Kerala, Venjarammoodu

FFForororm No. 136 UNIVERSITY OF Application for Pre-Registration

(Please read the instructions in page 3 & 4 before filling up the form) AAA. General Details 1. Name of the Course

A passport 2. Specialisation 3. Course Code size Photograph to be attested by the Head of the Institution 4. Name of the Institution (use abbreviations, if needed)

5. Admn. Year 6. Institution Code Signature of the Candidate

B. Personal Details 7. Name of the Candidate (leave space between words)

8. Date of Birth (DD - MM - YY) 9. Sex (F/M) 10. Religion 11. Community

12. Reservation Catagory (‘C’-SC, ‘T’-ST, ‘B’-OBC, ‘O’-Other reserved category, ‘N’-No reservation) 13. Communication Address (leave space between words)

Pin 14. Phone No. with STD Code (if any)

15. e-Mail Address (Use one column for each character)

Other Reservation Categories (Give P mark in appropriate columns) 16. Sports 17. Ex-Service/Dependent 18. Handicapped 19. Repatriate 20. NCC 21. NSS 22. Teaching Experience 23. If yes for (22), give length of service (If in regular service in Govt. / Aided Institutions) Year Month

C. Qualifying Examination Details 24. Name of Course 25. Specialisation / Group

26. Name of the Institution (use abbreviations, if needed)

27. Course Code 28. Course Type 29. Institution Code 30. Institution Type 31. University / Board

32. Register No / Candidate Code 33. Scheme Code 34. Sem/Year 35. Exam Month 36. Exam Year

D. Details of Marks of Qualifying Exam (read instructions for section D carefully)

Subjects Marks awarded Maximum Marks 37. 38. 39.

40. 41. 42.

43. 44. 45.

46. 47. 48.

49. 50. 51.

52. 53. 54.

55. 56. 57.

58. 59. 60.

61. 62. 63.

64. Class / Division 65. GPA / Percentage 66. Whether Original Certificate attached (Y or N)

67. Have you been given any ID-number earlier (Y / N) If Yes, give details in (68) and (69) 68. Course Code 69. Temporary ID alloted

E. Fee Details 70. Eligible for fee concession (Y or N) 71. Draft No / Chalan No.

72. Date of Payment (DD MM YY) 73. Name of the Bank or Friends / Cash Counter

74. Amount Rs. 75. Location of the Bank or Friends / Cash Counter

FFF... Matriculation Details

76. Institution last attended 77. Valid Matriculation Order No. (of Kerala Univeristy)

78. University affiliation of Institution ( If applicable) 79. Date of Matriculation Order ( If applicable)

DECLARAAATION CERTIFICATE

I hereby declare that the entries made in this application form are I hereby certify that the information furnished by the candidate in true to the best of my knowledge and that they have been made this application has been verified by me and that I have found them to agree with the records available in this office. The candidate in my own hand writing. has a valid matriculation in this University with Matriculation No. dated ...... Place : Date : Date : Signature of the Applicant Signature of the Principal

Office seal

2 Design & Typesetting by K.U.C.C Instructions to fill up Application form (form No.136)

Use one column for each character. If number of columns is insufficient, use abbreviations already in use or mention only the first three letters of each word with a blank space in between.

AAA 1. Give the name of the course to which you are admitted. Eg: For MSc M S c 2. Give the specialization of the course to which you are admitted. Eg. For Physics P H Y S I C S 3. Give the code of the course to which you are admitted. Course Code is a three digit number representing each course under Kerala University. See Table -1 attached. 4. Eg. For Sree Narayana College, Kollam S N C O L L E G E K O L L A M 5. Admission Year - Indicate the last two digits of the academic year of admission of the candidate to the present course. 6. Institution Code - See the Table-2 for Institution Codes. BBB 7. Give the name as in the certificate of qualifying examination. Leave space between adjacent parts of the name. Eg. For SMITHA S DHARAN S M I T H A S D H A R A N 8. The format is DD MM YY Eg:- 24 May 1980 as 2 4 0 5 8 0 9. Write M or F as applicable in the box space provided. 10. Give your religion. 11. Write the community you belong to. 12. Categories eligible for reservation should mention the respective code here. ‘C’, ‘T’ and ‘B’ are for SC, ST and OBC . Other categories eligible for reservation should indicate ‘O’ . Those who are not under reservation category should indicate ‘N’. 13. Write your communication address leaving space between words. Pincode should also be written. 14. Give your phone number, if any. 15. Give your e-mail address. 16-22 Put tick marks in columns which are applicable. Item No.22 is applicable only to candidates admitted based on teaching experience also. 23. If you have teaching experience, give length of service. CCC Details of the examination which makes the applicant eligible for the course applied for. 24. The qualifying course on the basis of which the candidate is seeking admission. eg : BA or BSc 25. The specialization of the qualifying course. eg: ECONOMICS If the specialisation needs more than twelve characters mention only the first three letters of each word of specialisation separated by blanks. Eg: MANAGERIAL ECONOMICS can be written as M A N E C O 26. Give the name of the institution in which the candidate studied for the course. Item Nos 27-30 are applicable only to those candidates who have passed the qualifying course from Kerala University. 27. This item is applicable to those applying for PG courses only. Write the code number of the qualifying course. See Table -1 attached. 28. This item is applicable to those applying for PG Courses only. Write ‘1’ for course having one main and two subsidiaries, ‘2’ for two main course, ‘3’ for three main course, ‘4’ if all subjects are of equal importance ‘5’ if final year subjects are of equal importance & ‘6’ for others. 29. This item is applicable to those applying for PG Courses only. See Table-2 for Institution Codes. 30. This item is applicable to those applying for PG Courses only. Write ‘1’ if the candidate has completed the qualifying course in a University Department, write ‘2’ if Affiliated College ‘3’ if Study Centre under Distance Education Scheme of Universities and ‘4’ if others. The applicant who completed the course under Distance Education Scheme in a study centre which is also an Affiliated College under any University shall indicate ‘3’ against item no. 30. 31. This item is applicable to those applying for PG Courses only. Write name of the University from where the candiate passed the qualifying examination. 3 32. Register Number / Candidate Code of the candidate in the qualifying examination. 33. For candidates seeking admission to graduate courses, write ‘01’ for Plus II, ‘02’ for CBSE and ‘03’ for ICSE, ‘04’ for Pre- Degree, ‘05’ for Diploma and ‘06’ for others. For candidates seeking admission to Post-graduate courses, give the last two digits of the year of introduction of the scheme in which the candidate passed the qualifying examination from the respective University. 34. Write ‘S’ if semester system was followed for the qualifying course and ‘Y’ if yearly system was followed for the qualifying course. 35. Month of qualifying examination. 36. Year of qualifying examination. The last two digits of the year of qualifying examination should be written. eg. 01 or 02 for 2001 and 2002 respectively. D. Details of how to fill up mark details This section gives provision for filling up the marks obtained in 9 different Groups. Each row is meant for a group. For eg. A chemistry graduate applying for the MSc Course will fill up the rows as follows. English, Second language, Main subject & each of the subsidiary subjects are considered separate groups. WWWrite the subject name (viz ENGLISH) against item no.37, total marks secured for all the papers in ENGLISH against item no.38 & maximum marks for ENGLISH against item no.39. Similarly write the subject name of Second Language (eg. , Hindi ...) against item no.40 and so on. Subjects Marks awarded Maximum Marks 37. E NG L I S H 38. 1 5 0 39. 3 0 0

40. M A L AYA L A M 41. 1 2 0 42. 2 0 0

43. C H E M I S T R Y 44. 2 4 0 45. 6 0 0

46. M A T H E M A T I C S 47. 1 5 0 48. 2 0 0

49. P HY S I CS 50. 0 8 0 51. 2 0 0

52. 53. 54.

64. Enter ‘D’, ‘F’, ‘S’, or ‘T’ for Distinction, First, Second or Third. 65. Give GPA or Percentage of marks obtained by the candidate in the qualifying examination. 66. Write ‘Y’ if original certificates are attached and ‘N’, otherwise. 67. Write ‘Y’ if the candidate has applied for pre-registration and received temporary ID earlier from this University and ‘N’, otherwise. 68. If the candiate had been given temporary ID number earlier from this University, give the code of the respective course joined earlier. See Table-1 for course codes. 69. Give the temporary ID alloted to the candidate . E.E.E. Fee can be remitted either by cash at University Cash Counter/ ‘Friends’ counters or by Demand drafts drawn in favour of “““The Finance Officer, , ”. Please note that, drafts payable at SBT Service Branch, Thiruvananthapuram or Kerala State Co-operative Bank Head Office Branch, Thiruvananthapuram only will be accepted from Candidates residing within the State. Those residing outside the State may submit SBI drafts payable at SBI Main Branch, Thiruvananthapuram. 70. Those who are eligible for fee concession should indicate ‘Y’ others should indicate ‘N’ 73. The name of the Bank / Counter where the fee is remitted. If columns are insufficient, the first three letters of each word should be mentioned. 74. Give the amount of the Bank Draft being enclosed or cash remitted as Pre-registration fee. 75. Location of the Bank / Counter where the fee is remitted. FFF 76. If the candidate had his immediate past studies in some other University (or equivalent) and/or had obtained migration to that University (or equivalent) the name of the college and University should be mentioned against item no. 76 and 78 respectively, (even if it is not relevant to the present course of study) 77. A candidate is a matriculate of University of Kerala, if a migration certificate has not been issued in favour of him corresponding to (or after the issue of) the latest order of matriculation certificate issued for him from this University. If the matriculation order given to the candidate for an earlier course under this University is still valid, the candidate can skip item no. 77& 79. If matriculation order is awaited, enter ‘99’ in the last two columns for item no.77 and leave item no. 79 blank. 78. If more than twelve characters are needed, mention only the first three characters of each word (separated by blanks). The first three characters of the name of the state also should be included at the end. The word ‘University’ can be ignored. Eg: For , Kerala C A L K E R

4 Design & Typesetting by K.U.C.C TTTABLE - I COURSE CODES

105 BA Philosophy 248 BSc Biochemistry and Industrial Microbiology (Restructured) 110 BA Sanskrit Lang & Literature 250 BSc Zoology 111 BA Sanskrit Special 251 BSc Industrial Fish & Fisheries (Voc) 115 BA Malayalam Language and Literature 252 BSc Biological Techniques and Specimen Preparation (Voc) 116 BA Malayalam & Mass Communication (Restructured) 255 BSc Home Science 119 BA Malayalam (IDE) 256 BSc Clinical Nutrition and Dietetics (Voc) 120 BA Tamil Language & Literature 257 BSc Physics and Electrical Equipment Maintenance 125 BA Hindi Language & Literature (Restructured) 126 BA Functional & Hindi (Voc) 260 B.Ed 130 BA English Language & Literature 265 LLB 131 BA Communicative English 268 BAL 132 BA Communicative English OR Functional English (Voc) 275 BLISc 133 BA English and Communicative English (Restructured) 285 BSc Medical Laboratory Technology 134 BA English (IDE) 305 BTA 135 BA Arabic Language & Literature 310 BSc Physical Education 140 BA History 315 BA Social Work 141 BA Islamic History 320 BSc Computer Science 144 BA History (IDE) 328 BSc Physics and Computer Applications (Restructured) 145 BA Politics 329 BSc Computer Science (IDE) 149 BA Politics (IDE) 330 BSc Computer Applications (Voc) 150 BA Economics 331 BCA (IDE) 154 BA Economics (IDE) 332 BCA (Regular) 155 BA Business Economics 333 B.Com Computer Applications (IDE) 160 BA Sociology 334 B.Com Tax Procedure & Practice (Voc) 161 BA Sociology (IDE) 335 BPE 165 BA Psychology 336 B.Com Actuarial Science (Voc) 175 BA Music 337 B.Com Commerce & Tax Procedure and Practice (Restructured) 176 BPA 338 B.Com Commerce & Tourism and Travel Management 177 BFA (Restructured) 180 BA Public Administration 339 B.Com Commerce & Hotel Management and Catering 185 BA Personnel Management (Restructured) 186 BA Mass Communication and Video Production 340 BSc Electronics 187 BA Mass Communication and Video Production (Voc) 350 BSc Bio-technology 188 BA Journalism & Mass Communication and Video 351 BSc Bio-technology (Voc) Production (Restructured) 352 BSc Life Science 189 B.Com Office Management and Secretarial Practice (Voc) 353 BSc Forestry 190 B.Com 354 BSc Marine Biology 191 B.Com Computer Applications 355 BSc Micro Biology 192 B.Com (Three Main: Commerce, Accounting & Computer 356 BSc Environmental Chemistry Applications) 401 B.Tech Civil Engineering 193 B.Com Tourism & Travel Management (Voc) 402 B.Tech Polymer Technology 194 B.Com Co-operation (IDE) 403 B.Tech Mechanical Engineering 195 BBA 404 B.Tech Mechanical Stream - Production Engineering 205 BSc Geography 405 B.Tech Mechanical Stream - Automobile Engineering 210 BSc Geology 406 B.Tech Mechanical Stream - Industrial Engineering 215 BSc Environmental Science 407 B.Tech Chemical Engineering 216 BSc Environmental Sciences and Water Management 408 B.Tech Biotechnology (Restructured) 411 B.Tech Electrical & Electronics Engineering 220 BSc Mathematics 412 B.Tech Electronics & Communication Engineering 224 BSc Mathematics (IDE) 413 B.Tech Applied Electronics & Instrumentation Engineering 225 BSc Statistics 415 B.Tech Computer Science & Engineering 230 BSc Physics 416 B.Tech Information Technology 231 BSc Optical Instrumentation (Voc) 421 B.Tech Civil Engineering (PT) 232 BSc Physics and Optical Instrumentation (Restructured) 422 B.Tech Mechanical Engineering (PT) 233 BSc Instrumentation (Voc) 423 B.Tech Electrical & Electronics Engineering (PT) 234 BSc Electrical Equipment Maintenance (Voc) 424 B.Tech Electronics & Communication Engineering (PT) 235 BSc Chemistry 425 B.Tech Computer Science & Engineering (PT) 236 BSc Analytical Chemistry 455 B.Arch 237 BSc Applied Chemistry 461 MBBS 238 BSc Bio-Chemistry 465 BDS 239 BSc Polymer Chemistry 470 B.Pharm 240 BSc Industrial Chemisry (Voc) 475 BSc Nursing 241 BSc Chemistry and Industrial Chemistry (Restructured) 476 BASLP 245 BSc Botany 480 BAMS 246 BSc Industrial Microbiology (Voc) 490 BHMS 247 BSc Botany and Biotechnology (Restructured) 505 M A Philosophy 610 M Sc Geology 510 M A Sanskrit Language & Literature 615 M Sc Environmental Science 511 M A Sanskrit Special 620 M Sc Mathematics 515 M A Malayalam 625 M Sc Statistics 520 M A Tamil 630 M Sc Physics 525 M A Hindi 635 M Sc Chemistry 530 M A English 636 M Sc Analytical Chemistry 535 M A Arabic Language & Literature 637 M Sc Applied Chemistry 540 M A History 638 M Sc Bio-Chemistry 541 M A Islamic History 639 M Sc Polymer Chemistry 545 M A Politics 645 M Sc Botany 550 M A Economics 650 M Sc Zoology 555 M A Business Economics 654 M Sc Computer Science 560 M A Sociology 655 M Sc Home Science - Family Resource Management 565 M A Psychology 656 M Sc Home Science - Extension Education 570 M A Fine Arts 657 M Sc Home Science - Food & Nutrition 575 M A Music 659 M Sc Bio-Technology 580 M A Public Administration 905 M T A Tourism Administration 585 M A Personnel Management 910 M P E Physical Education 590 MCom 915 M S W Social Work 595 M B A Management 916 MPSW Psychiatric Social Work 605 M Sc Geography TTTABLE - II INSTITUTION CODES Engineering Colleges Study Centres 400 College of Engineering, Thiruvananthapuram 011 Institute of Cooperative Management (ICM), * 401 Government College of Engineering,Barton Hill, Thiruvananthapuram 012 Keltron IT Education Centre, * 402 S.C.T College of Engineering, Pappanamcode, TVM 013 Keltron IT Education Centre, Spencer Jn* 403 T.K.M.College of Engineering, Kollam 014 Carmel Polytechnic, * 404 University College of Engineering, Kariavattom 015 Keltron IT Education Centre, Cochin* 405 KVM College of Engineering, Chertala 016 Keltron IT Education Centre, Trichur* 406 LBS Institute of Technology for Women, Thiruvananthapuram 017 Keltron IT Education Centre, Calicut* 407 Marian College of Engineering & Technology, Kazhakuttam 018 Keltron IT Education Centre, Thalassery* 408 Mar Baselios College of Engineering & Technology, 019 Keltron IT Education Centre, * 409 Mohandas College of Engineering & Technology, , 020 Keltron IT Education Centre, Palakkad* 410 Amritha Institute of Technology & Science, Vallickavu 021 Keltron IT Education Centre, Manjery* 411 Baselios Mathews II College of Engineering, Sasthamcotta 030 Keltron IT Education Centre, Kollam* 412 Shahul Hameed Memorial College of Engineering, Kadakkal 031 CACEE (Centre of Adult, Continuing Education & Extension) 413 Lourdes Matha College of Science & Technology, 099 Institute of Distance Education, Kariavattom* 414 Sree Buddha College of Engineering, Nooranad Arts and Science Colleges 415 Muslim Association College of Engineering, 416 Younus College of Engineeing & Technology, Vadakkenada, Kollam 100 All Saints’ College, Thiruvananthapuram 417 Engineering College, Oyoor 101 Bishop Moore College, * 102 Christian College, * Fine Arts Colleges 103 Christian College, 450 College of Fine Arts, Thiruvananthapuram 104 D.B.College, Sasthamcottah 451 Sree Swathi Thirunal College of Music, TVM 105 F.M.N.College, Kollam* 452 College of Fine Arts, Mavelikkara, Alappuzha 106 Govt. Arts College , Thiruvananthapuram Physical Education 107 Govt. College For Women, Thiruvananthapuram 108 Govt. College, Kariavattom* 500 L.N.college of Physical Education, Kariavattom 109 Govt. Sanskrit College, Thiruvananthapuram Law Colleges 110 Govt.College, * 550 Govt. Law College, Thiruvananthapuram 111 Govt.College, Chavara 551 The Kerala Law Academy Law College, TVM 112 Govt.College, Nedumangad Medical Colleges 113 Iqbal College, * 114 K.N.M. Govt.College, 600 Medical College, Thiruvananthapuram 115 Loyola College of Social Sciences, Sreekariyam 601 T.D.Medical College, Alappuzha 116 M.M.N.S.S.College, Kottiyam* Dental College 117 M.S.M.College, * 650 Govt. Dental College, Thiruvananthapuram 118 , Thiruvananthapuram Homeopathic Medical Colleges 119 Mannaniya College of Arts And Science,,Kallara 120 , Thiruvananthapuram* 700 Govt. Homoeopathic Medical College, TVM 121 N.S.S.College For Women Neeramankara TVM 701 Shri Vidyadhiraja Homoeo Medical College, 122 N.S.S. College, Chertalla Thiruvananthapuram (Private) 123 N.S.S. College, Pandalam Ayurveda College 124 N.S.S.College, Nilamel 750 Govt. Ayurveda College, Thiruvananthapuram 125 S.D.College, Alappuzha 126 S.G.College, Kottarakara Unaided Colleges 127 S.N. College , 800 A.J.College of Science And Technology 128 S.N. College, Chengannur , Thiruvananthapuram* 129 S.N.College For Women, Kollam 801 C.H.M.M.College of Advanced Studies, Palayamkunnu,* 130 S.N.College, Chathannur 802 College of Applied Science, 131 S.N.College, Chertalla 803 College of Applied Science, Mavelikkara 132 S.N.College, Kollam* 804 Emmanuel College, , Thiruvananthapuram 133 S.N.College, 805 K.V.V.S. College, Kaithaparambu, Adoor 134 S.N.College, Sivagiri, Varkala* 806 Marthoma College of Science And Technology, Ayur 135 Sree Ayyappa College, Thiruvanvandoor, Chengannur 807 National College, Ambalathara, Thiruvananthapuram* 136 St. Michael’s College, Chertalla* 808 S.S.Vidhya Peetom College,, * 137 St.Cyril’s College, Adoor 809 Sree Vidyadhiraja Arts and Science College,Karunagappally 138 St.John’s College, Anchal* 810 T.K.M.Institute of Management, Kollam 139 St.Joseph’s College For Women, Alappuzha 811 Member Sree Narayana Pillai Institute of Management & 140 St.Stephen’s College, Technology, Chavara, Kollam. (date as on 23..09..03) 141 St.Xavier’s College, Thumba 142 T.K.M.College of Arts & science, Kollam University Institute of Technology 143 T.K.M.M.College, Nangiarkulangara 950 UIT, Kuravankonam,Trivandrum* 144 University College, Thiruvananthapuram 951 UIT, ,Trivandrum* 145 V.T.M.N.S.S. College, 952 UIT, Mulamkadu, Kollam* Training Colleges 953 UIT, Thiruvambady* 954 UIT, Adoor, 300 College of Teacher education, Thiruvananthapuram 955 UIT, Near Seema Theatre, Govt.Hospital Road, Pathanapuram, Kollam* 301 Karmela Rani Training College, Kollam 956 UIT, HS, Pirappancode* 302 Mar Theophilus Training College, Thiruvananthapuram 303 Mount Tabor Training College, Pathanapuram 957 UIT, Alappuzha 304 N.S.S.Training College, Pandalam University Teacher Education Centres 305 Peet Memorial Training College, Mavelikkara 970 UTEC, Victoria HS Campus, Olathani, 306 S.N.Training College, Nedunganda, Varkala Neyyattinkara, Thiruvananthapuram Training Colleges (Private – unaided) 971 UTEC, Govt.Medical College, HSS Kumarapuram,TVM 350 Baselios M.M.I I Training College, 972 UTEC, Govt. UPS,,Trivandrum 351 C. S. I College of Education, 973 UTEC, GHSS for Boys, Kollam 352 Fathima Memorial Training College, Kollam 974 UTEC, Govt. HS Kulakkada, Kollam 353 K.N.M.S Training College, 975 UTEC, GHS Campus, Anchal West,Anchal, Kollam 354 M.M. Training College, Vilakkudy, Pathanapuram 976 UTEC, Govt. HS for Boys, Ariyad, Alappuzha 355 National Training College For Women, 977 UTEC, HS Chathiyara, Thamarakulam, Alappuzha Kollamkavu, Pazhakutty, Nedumangad 978 UTEC, Govt. HS for Boys,Kayamkulam, Alappuzha 356 National Training College,Pravachambalam,Thiruvananthapuram 979 UTEC, Govt. GHS for Boys,Adoor, Pathanamthitta