Model for ONLINE APPLICATION

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1 Model for ONLINE APPLICATION Annexure - A (FORM A) (Bi.P.C. Stream) Common application for U.G. admission into various courses & colleges in ANGRAU, SVVU and DR. YSRHU for the academic year Application for admissions into B.Sc.(Hons) Agriculture / B.Tech.(Food Technology)/ B.V.Sc. & A.H./ B.F.Sc./ B.Sc.(Hons.) Horticulture Courses in Acharya N.G. Ranga Agricultural University (ANGRAU), Guntur Sri Venkateswara Veterinary University (SVVU), Tirupati & Dr.Y.S.R. Horticultural University (Dr.YSRHU), Venkataramannagudem, W.G. Dist. If you are an applicant for more than one course, indicate preference in order of priority 1 st 2 nd 3 rd 4 th 5 th Passport Size Photo 1. Name of the applicant in full (in block letters) : 2. a) Father s Name : b) Mother s Name : 3. Particulars of AP EAMCET 2018 : a) Rank obtained (State level) : Hall Ticket No.: b) Marks obtained in intermediate : Biology ( ) Physics ( ) or its equivalent exam Chemistry ( ) English ( ) 4. Social Status of the candidate (Please Tick in the relevant box) OC BC-A BC-B BC-C BC-D BC-E SC ST 5. Place of study from 6 th Class to Intermediate / 12 th standard: S.No. Class Academic Year 1. VI Class 2. VII Class 3. VIII Class 4. IX Class 5. X Class Inter 1 st year / XI Class Inter 2 nd year/ XI Class Name and place of the school / institution in which studied District

2 6. Are you a candidate seeking admission under any of the following categories? (Mark Yes/ No ). If so, enclose the relevant certificate(s). Defence Physically Challenged NCC Sports & Games Yes No Yes No Yes No Yes No 7. Are you a candidate from agriculturists family? : Yes / No If so, please furnish the relevant information in the prescribed forms I & II only in this application form 8. Annual income of father/mother : 9. Date of birth (as per SSC/CBSE/ICSE certificate) : 10. Please furnish the following details : (A) (B) (C) Candidate: Father : Mother: Place of Birth Mandal District State 11. Online Payment through (Net Banking / Debit Card / Multiple Gate Way) Rs.1300/- ( Rs. 650 in case of : SC/ST/PH candidates) towards registration fee 12. Address for Correspondence along with : Phone Nos. (Mobile only) - Compulsory

3 13. List of Enclosures: (Attested xerox copies only) 1) Pass Certificate cum Memorandum of Marks obtained by the candidates in the qualifying examination ( Intermediate or its equivalent ) 2) Hall Ticket & Rank Card of AP EAMCET ) SSC or equivalent certificate, showing the evidence of the Date of Birth. 4) In case of the candidates belonging to Backward Classes, Scheduled Castes and Scheduled Tribes, latest certified copy of the Social Status Certificate issued by the competent authority. 5) Xerox copies of Bonafide / Study Certificates from 6 th to 12 th Class. 6) Residential Certificate. Note: Such of the students who are having a break in the years of study for reasons other than failure or those who passed the qualifying examination by private study have to submit this certificate issued by the Mandal Revenue Officer/ Tahsildar. In case, the students have resided in more than one place, separate certificate from the Mandal Revenue Officer/ Tahsildar, should be furnished for such places of residence. 7) Forms required for the candidates eligible under Farmers Quota seats (40% in ANGRAU and Dr.YSRHU and 25% in SVVU) (Please see the Information Brochure for details) a. FORM-I: It is a proforma indicating the patta numbers and extent of land owned by the candidate / parents duly certified by the Mandal Revenue Officer / Tahsildar with office seal (or) the candidate has to enclose attested xerox copies of pattadar pass book as an evidence of the extent of land. b. Form-II: It is a proforma to be certified by the Head Master of the School with office seal that the candidate has studied for a minimum period of four years in schools located in Non-Municipal areas during their period of study from 1 st class to 12 th class / Intermediate (Non-Municipal Area Certificate). c. Form-I and Form-II need to be filled in with the signatures of concerned officials viz., Mandal Revenue Officer / Tahsildar and concerned Head of Institution, respectively, along with office seal. Otherwise, the claim of the candidates under this category will be summarily rejected. 8) Online payment (through Net Banking / Debit Card / Multiple Gate Way) of Rs. 1300/- (Rs.650/- in case of SC/ST/PH candidates) towards the registration fee (Non-refundable).

4 CLAIM UNDER AGRICULTURIST - CUM - RURAL AREA QUOTA FORM - I AGRICULTURIST CERTIFICATE This is to certify that Mr. /Ms... Son / Daughter of.. comes from an Agriculturists Family. He/ She/ His/Her parent(s) owns lands as detailed below* Mandal Village Patta No./Khata No. Survey No. Area (In Acres / in Guntas *Total Area in words Place : Signature of Mandal Date : Office Seal Revenue Officer / Tahsildar

5 CLAIM UNDER AGRICULTURIST - CUM - RURAL AREA QUOTA FORM II NON-MUNICIPAL AREA CERTIFICATE TO BE PRODUCED BY THE CANDIDATES COMING FROM AGRICULTURISTS FAMILIES Certified that Mr./ Ms.. Son / Daughter of.. has studied in this school/ Institution in classes during the period as indicated below; and also certified that this school (Name of the school).. Village Mandal.District located in Non-Municipal area. is Class Academic Year Office Seal: Signature of the Head Master / Head Mistress of the School / Institution Note: In case of a student studied in different schools/institutes, separate typed certificates in the above format only duly signed by the Heads of Schools/Institutions where he/she had studied, should be enclosed failing which he/she will not be considered under this category.

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