2 Years - 4 Semesters (Offered for BOYS & GIRLS)

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Brahmasthanam, Edappally North (P.O.), Kochi - 682 024, Kerala

Tel: 0484 - 280 2899, 280 1489, 280 1965 Fax: 0484 - 280 2511

Email: asaskochi@gmail.com, admissions.asaskochi@gmail.com

Application Form Number

WMAE

M.A. (ENGLISH LANGUAGE & LITERATURE)

Application Form for Admission (2019) to Post Graduate Programme

Please read the INSTRUCTIONS TO CANDIDATES and FAQ before filling this Application Form. All entries

to be made in BLOCK LETTERS. Fill in all the details in CANDIDATES OWN HANDWRITING. Enclose

ONLY self – attested photocopies of Marklists. INCOMPLETE APPLICATION FORM is liable for rejection.

1. Name of the Applicant as given in the S.S.L.C. Book (leave blank space between first name and initials)

Page 1 of 4

Place:

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

DECLARATION BY PARENT / GUARDIAN

I, undertake the responsibility of my daughter/ward

who is seeking admission in the Amrita School of

Arts and Sciences, Kochi Campus of Amrita Vishwa Vidyapeetham and declare that the particulars furnished by him/her is correct and true and that if

in future, any information is found to have been furnished falsely or incorrectly or any information suppressed to secure admission, I shall withdraw my

daughter / son from the course without any claim or consideration of the period of study/stage of the course she/he completed. I hereby ensure that the

candidate has read the “Instructions to Candidates” and “FAQ” before filling this Application Form. I shall not claim refund of fees already paid in the

event of discontinuance of the study.

(Name and Signature of Parents)

Father:

Mother:

Name and Signature of Guardian other than Parents (If Applicable):

Relationship with the Applicant:

I fully agree with the above declaration. I fully agree to abide by the rules and

regulations of Amrita School of Arts and Sciences, Kochi if admitted to the course.

FOR OFFICE USE ONLY

Fees Paid: Rs.

Rt. No.:

D.D.:

Semester:

C.D.Rt. No.:

Bank:

Page 4 of 4

DECLARATION BY THE APPLICANT

I S/o. / D/o. of

hereby declare that the particulars given by me in this Application Form are true. I shall produce the original certificates at the time of admission.

I confirm having read and understood the “Instructions to Candidates” and “FAQ” before filling this Application Form.

Place:

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

3. Gender: Male / Female 4. Blood Group:2. Date of Birth: Age:

5. Place of Birth: District: State:

7. Mother Tongue: 8. Nationality: 9. Marital Status:

10. (A) Address for Communiction:

Post Office: District:

Phone No. (with STD Code): E-mail:

Father’s Mobile Number: Father’s E-mail ID:

Mother’s Mobile Number: Mother’s E-mail ID:

State: Pin:

10. (B) Permanent Address:

Post Office: District:

State: Pin:

6. Religion: Caste: Community (SC/ST/OBC/OEC/Gen/Others):

Applicant’s Phone No:

12. Name and Address of Local Guardian (if any):

13. Name of the College / Institution last studied for the qualifying examination:

Post Office: District:

a) Name of the College / Institution:

b) Address with Pincode:

c) Name of the Degree: d) YEAR WISE / SEMESTER WISE

e) Month and Year of Passing: f) University:

g) Subjects – Main: Ancillary:

Phone No. (with STD Code): E-mail:

Relationship with Student:

State: Pin: Mobile:

Page 2 of 4

11. (A) Father’s Name:

Occupation (specify): Annual Income:

Office Address with Phone No. (if any):

11. (B) Mother’s Name:

11. (C) Do you have Brothers or Sisters ? If yes, give their names:

Occupation (specify): Annual Income:

Office Address with Phone No. (if any):

11. (D) Husband’s Name (In case of married female candidate):

Occupation (specify): Annual Income:

Office Address (if any):

Contact Number (Mobile and Landline with STD Code):

E-Mail ID:

14. What is the present stage of your study: Course completed / Appeared in final examination / Result awaited / Qualified

(strike out whichever is not applicable)

(Enclose self - attested photocopies of ALL the Marklists / Grade sheets of the Degree exams)

(Enclose self - attested photocopies of 10th and 12th mark sheets)

15. Marks obtained in the qualifying examination:

18. Marks obtained for 10th and 12th standard:

19. Major Extra Curricular Activities:

16. Subjects for which more than one attempt was made:

17. Month and Year of passing:

20. Reason for choosing the AMRITA school for your studies:

If the Degree was of annual (year) pattern, use only the first three columns to enter marks.

Semester / Year I

Marks Obtained

Maximum Marks

% of Marks / Grade Point

II III IV V VI Total

Class Marks Obtained

10th

12th

Maximum Marks % of Marks No. of Attempts

No. ActivityFrom To

YearHonours Received (if any) Remarks

Page 3 of 4

21. How did you come to know of Amrita School of Arts and Sciences, Kochi Campus ?

Alumni TV Channels MA Math Matruvani College / School last studied

The Hindu Indian Express Mathrubhumi Malayala Manorama Janmabhumi Kerala Kaumudi

Amrita WebsiteFacebook Others (specify)