BERHAMPUR UNIVERSITY BHANJA BIHAR, BERHAMPUR , ODISHA

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PROSPECTUS AND APPLICATION FORM SELF-FINANCING COURSES, 2015-16 THREE YEAR EXECUTIVE MBA TWO YEAR MBA (FINANCIAL MANAGEMENT) and M.TECH. (ENVIRONMENTAL SCIENCE) BERHAMPUR UNIVERSITY BHANJA BIHAR, BERHAMPUR 760 007, ODISHA

PROSPECTUS and APPLICATION FORM FOR ADMISSION TO SELF-FINANCING COURSES - 2015-16 THREE YEAR EXECUTIVE MBA TWO YEAR MBA (FINANCIAL MANAGEMENT) and M.TECH. (ENVIRONMENTAL SCIENCE) I. SCHEDULE i. Date of Notification 30.06.2015 (Tuesday) ii. Last date of Receiving the Filled in Application Form along with documents 10.08.2015 (Monday) iii Date and time of Entrance Test 23.08.2015 (Sunday) 11.00 A.M. to 1.00 P.M. iv. Date for Viva Voce Test (in case of three years Executive MBA.) 04.09.2015 (Friday) v. Sending of intimation letters to candidates (both Merit List and Waiting List) Last date for receiving documents from candidates in Merit vi. List and waiting list Last date for finalization of admission and sending the list of vii provisionally admitted candidates along with their applications, required documents. viii. Date of commencement of classes. 07.09.2015 (Monday) 22.09.2015 (Tuesday) 25.09.2015 (Friday) 28.09.2015 (Monday) Note : Admission into Executive MBA, M.Tech (Environmental Science) and MBA (Financial Management) shall be through Entrance Test from the session 2015-16. Details of which shall be advertised and uploaded to the University Website. II. COURSES OFFERED: 1. Executive MBA Sl.No Courses Duration No. of Seats Offered by the Department 1 Executive MBA 6 Semesters (Three years) 30 Business Administration 2 MBA (Financial Management) 4 Semesters 32 Commerce (Two years) 3 M.Tech (Environmental Science) 4 Semesters (Two years) 16 Chemistry The above courses shall ordinarily be offered with a minimum of 10 students in each course. 1

III. ELIGIBILITY FOR ADMISSION (a) Three years Executive MBA : Any Graduate with a minimum of 45% of marks in the aggregate or in the honours subject for the candidates belonging to the general category (a minimum of 40% of marks in the aggregate or a minimum of 45% in the honours subjects for the candidates belonging to the Scheduled Castes and the Scheduled Tribes) is eligible for consideration for admission. Besides above, the candidate with two years of work experience in any registered/ private/ Autonomous organization shall be eligible to apply for admission into the Three year Executive MBA Programme. Entrepreneur and self employed person with own/ SSIS, Valid license, TIN, PAN etc and professionals such as Doctors, Engineers, Chartered Accountants, Cost Accountants, Company Secretaries, Legal Practitioners with two year experience will also be eligible for admission. (b) M. Tech. (Environmental Science) : The candidate should have either M.Sc. (Chemistry/Botany/Zoology/Marine Science) or B.Tech / B.E. with minimum 50% marks or equivalent CGPA in the aggregate in qualifying examination for General Category and 45% marks in aggregate for the candidates belonging to SC and ST Category. (c) MBA (Financial Management) : Any Graduate with a minimum of 50% marks in aggregate or in Honours for General Category and 45% marks or equivalent CGPA in aggregate for the candidates belonging to SC and ST Category. FOR ATTENTION OF ALL APPLICANTS The applicants before applying to any of the above courses are advised to carefully go through the Prospectus and visit the University Website (www.buodisha.edu.in) to know about the profile of the University. They are also advised to visit the University Campus, Bhanja Bihar, if they so desire and see for themselves the available infrastructure and other facilities. If satisfied, they may apply to any of the courses as per their eligibility. Once admitted, making any unreasonable demand thereafter shall not be entertained and it shall be treated as an act of indiscipline. IV. PROCEDURE FOR ADMISSION AND DETERMINATION OF MERIT Admission to all the above courses shall be governed by the Regulations of the University and Rules for Admission framed by the P.G. Council and duly approved by the competent authority. A candidate whose conduct is not satisfactory shall NOT be considered for admission. Merit shall be determined taking into account, the marks obtained in career points and entrance test (Written) for admission into MBA (Financial Management) and M.Tech in Environmental Science, where as in case of Executive MBA, total marks obtained in the entrance test (Written), career points, experience, and Viva-voce shall be considered for finalizing the merit list of candidates. 2

V. RESERVATIONS Reservations for the Scheduled Castes & Scheduled Tribes: 38.75 % of the seats in different courses are reserved i.e. for candidates belonging to the Scheduled Tribes (22.5%) and the Scheduled Castes (16.25%). For consideration under the Reserved Categories necessary certificate to this effect issued only by a Revenue Officer of the locality not below the rank of a Tahasildar must be submitted. VI. ENTRANCE TEST FEES: Each candidate has to deposit a sum of Rs. 1000/- (Rupees one thousands) only towards entrance fee drawn in favour of respective Course Coordinator in the form of a Demand draft/e-receipt payable at SBI, Bhanja Bihar, Code 2107. For example Course Coordinator, Executive MBA, Department of Business Administration; Course Coordinator, MBA (Financial Management), Department of Commerce; Course Coordinator, M.Tech (Environmental Science), Department of Chemistry. VII. ENTRANCE TEST DETAILS: Candidates for admission into the following courses shall be selected through an entrance test conducted by the respective Course Coordinators in the manner prescribed below. A) Three Year Executive MBA: (Written Exam. of Entrance Test: 50% + Career marks: 30% + Experience: 10% + Viva Voce: 10% = 100%) The written examination of entrance test shall be multiple choice based, and have 100 questions carrying 1 mark each, and there is no negative mark assigned for wrong answer. The entrance test will be of 2 Hours duration.the questions shall cover the following areas: i) Test of General knowledge in Business & economy ii) Test of General English iii) Test of Quantitative Aptitude iv) Test of Reasoning B) Two Year M.Tech (Environmental Science): (Written Exam. of Entrance Test: 50% + Career marks: 50% = 100%) The written examination of Entrance Test shall be multiple choice based, and have 100 questions broadly related to Environmental Science carrying 1 mark each and there is no negative marks for wrong answer. The Entrance est will be of 2 Hours duration. C) Two Year MBA (Financial Management): (Written Exam. of Entrance Test : 50% + Career marks: 50% = 100%) The written examination of Entrance Test shall be multiple choice based, and have 100 questions carrying 1 mark each, and there is no negative mark assigned for wrong answer. The Entrance test will be of 2 Hours duration. The questions shall cover the following areas: i) Test of General Knowledge in Business & Economy ii) Test of General English iii) Test of Quantitative Aptitude iv) Test of Reasoning 3

VIII.CAREER POINTS: Career marking for admission into Executive MBA and MBA (Financial Management) shall be as follows: Examination Passed 1 st Class 2 nd Class 3 rd Class H.S.C 15 12 8 Intermediate/ +2 25 18 12 Graduation i)honours 50 40 - ii)pass - - 30 iii)distinction 10 10 10 Career marking for admission into M.Tech (Environmental Science) shall be as follows: Examination Passed 1 st Class 2 nd Class 3 rd Class H.S.C 15 12 8 Intermediate/ +2 25 18 12 Graduation i)honours 50 40 - ii)pass - - 30 iii)distinction 10 10 10 M.Sc 60 40 - B.E/B.Tech (after +2) 110 80 Candidate who have submitted mark sheet in grade point scale are required to produce the equivalent marks from the institution, which has issued that mark sheet or the conversion formula certified by the institution along with the application. IX. APPLICATION PROCEDURE: PDF: Please download PDF Form from website: www.buodisha.edu.in Applicants are advised to apply in downloaded PDF form by visiting the website www.buodisha.edu.in Money orders and postal orders shall not be accepted under any circumstances. X. Procedure for depositing University fee online using State Bank Collect Facility: Fees can also be deposited using debit card, credit card, net banking facility of any bank. A link to SB.Collect is available in the University Website (www.buodisha.edu.in). Applicants are required to go through the following instructions carefully before depositing / remitting fees: Visit online banking website of SBI by typing https:/www.onlinesbi.com in the address bar of the browser viz. Internet explorer. Once the home page appears click on State Bank Collect tab. A link to the SB collect will also be available in the University website (www.buodisha.edu.in) which will take you directly to the SB Collect page for your online transaction. 4

On the SB collect page except the disclaimer clause and click on proceed select the state of corporate/institution as Odisha. Select type of corporate/institution as educational institutions and click on go. Now select education institution name as Berhampur University and click on submit. Select the desired payment category from the drop down. Fill in the Chalan with required information as asked for or select from the drop down options whenever available. Take adequate care while filling in (a) name (b) date of birth and (c) Mobile number as asked for in the lower part of the screen. This information is important to reprint the e-receipt in subsequent to any successful payment. Once the required data is filled in click on submit. The system will ask you to verify the detail entered and confirmed the transactions in the next page. Verify the details and click on the Confirm. The system request you to select the desired payment mode from various options. Please note that the bank charges for various payment modes are also displayed which is to be borne by the remitter. Carefully examine the charges displayed since the charges for different payment mode are different. Select the desired payment mode. Now the system will guide the remitter through the payment process. Once the payment is completed successfully on e-receipt is generated containing a Reference Number in PDF format. Take a print out. You may also save this optionally for future reference. The e-receipt can also be regenerated/reprinted afterwards from payment history link of state bank collect If SBI branch is selected as payment mode a pre acknowledgement Payment (PAP) form is generated which contains the relevant details for payment at Branch. The payer takes the print out of the PAP form and visit any SBI Branch for payment cash or cheque drawn on SBI Branch. After the payment is successfully processed by the branch, the branch will give an acknowledgement of payment on the PAP form. Now any time the payer may optionally return to State Bank Collect link in the home page of www.onlinesbi.com for printing the e-receipt from the payment History link. XI. SUBMISSION OF APPLICATIONS FOR ADMISSION Candidates seeking admission into the different courses shall have to send their applications in the prescribed form duly filled in by them in their handwriting along with the required documents and fee (complete in all respects) to the Course Coordinator to which admission is sought by Registered / Speed Post. The application forms will not be accepted in person, either in the P.G. Central Office or by the Course Coordinator. The application along with the required documents and fee must reach the Course Coordinator on or before the prescribed date, i.e., August 10, 2015. University authorities shall not be responsible for postal delay. XII. POSTAL ADMISSION PROCEDURE For admission into all courses, the University has adopted Postal Admission System. The procedure of postal admission is as follows: 5

Merit List Candidates: After receiving the Intimation Letter for admission from the respective Course Coordinator, the candidate should send by Registered/ Speed Post all the required documents in original including a self addressed envelope and the prescribed fee in the form of Bank Draft (s). Waiting List Candidates: After receiving Intimation Letter, such candidates shall follow the same procedure for admission as laid down above for merit list candidates. Submission of documents by the Waiting List candidates is voluntary and at their own risk. The University does not guarantee admission to candidates kept in the Waiting List. Only after finalisation of admission of Merit List candidates, if seats remain vacant, the candidates in the Waiting List shall be considered for admission in order of their merit position in the Waiting List. As the admission of Merit List and Waiting List candidates is to be finalised simultaneously, the merit list and waiting list candidates are to send by Registered Post/Speed Post the required documents along with the prescribed fee within the date mentioned in the Intimation Letter. NOTE: (a) Submission of Transfer Certificate/College Leaving Certificate in original is compulsory for both Merit List and Waiting List candidates. (b) Applications incomplete in any respect are liable to be summarily rejected. No correspondence in the matter shall be entertained. (c) Failure to send the original documents and the required Bank Drafts/e-receipt as per Intimation Letter by the due date and time specified therein shall result in forfeiture of the claim for a seat. University Authorities shall not be responsible for postal delay. (d) The original documents and the Bank Draft(s)/e-receipt of candidates who are not admitted will be returned to them by Registered Post/Speed Post after the admissions are over. However, the concerned candidates can take back the original documents by submitting an application to the Course Coordinator before the completion of the admission procedure. For candidates who have been admitted, the original documents not required by the University, may be collected from the concerned Course Coordinator after the admission is finalised. (e) The decision of the Course Coordinator in all matters relating to admission shall be final and binding. XIII. FIELD STUDY, OBSERVATION, INTERNSHIP Etc. Students admitted to such subjects where the curriculum includes project work, field study, observation, internship, industrial visits have to undergo all such field study, observation, internship, Industrial visits at their own cost and risk as per rules. XIV. FEE AND CHARGES: (A) The following Annual Course Fee is to be paid at the time of Admission and Readmission in subsequent years: Course Fee Three year Executive MBA Rs. 20,000/- per year Two year MBA (Financial Management) Rs.30,000/- per year Two year M.Tech (Environmental Science) Rs.50,000/- per year 6

(B) In addition to the fee mentioned at XIV (A), the following fees are to be paid at the time of admission for MBA (Financial Management) and M.Tech. (Environmental Science) candidates only. 1. University Registration Fee Rs. 100.00* 2. University Recognition Fee Rs. 100.00* 3. Calendar Rs. 50.00 4. Magazine Rs. 50.00 5. Identity Card Rs. 50.00 6. Abstract of Attendance Rs. 10.00 7. Medical Aid Rs. 100.00 8. Library Fee Rs. 200.00 9. Student s Aid Fund Rs. 25.00 10 Admission / Re-admission (equal to one month s tuition fee) Rs. 12.00 11 Students Union Rs. 192.00 12 Dramatic Association Rs. 160.00 13 Athletic Association Rs. 160.00 14 Puja subscription Rs. 50.00 15 University Athletic Fee (Sports Council) Rs. 60.00 16 Common Room Fee Rs. 40.00 17 Transport Charge for each academic session (subject to change from Rs. 3200.00 time-to-time) 18 Fee for Cultural Activities (University) Rs. 40.00 19 NIS Rs. 05.00 20 NCC Rs. 05.00 21 Red Cross Rs. 05.00 22 Social Service (NSS) Rs. 10.00 23 Utility Fee (one-time) Rs. 1000.00 * Only for students from institutions other than Berhampur University. Fee once collected at the time of admission shall not be refunded under any circumstance. (C) In addition to the fees mentioned at XIV (A), the following fees are to be paid at the time of admission for Executive MBA candidates only. 1. University registration fee Rs. 100.00* 2. University recognition fee Rs. 100.00* 3. Calendar Rs. 50.00 4. Magazine Rs. 50.00 5. Identity Card Rs. 50.00 6. Abstract of Attendance Rs. 10.00 7. NIS Rs. 05.00 8. NCC Rs. 05.00 9. Red Cross Rs. 05.00 10. Social Service (NSS) Rs. 10.00 11. Medical Aid Rs. 100.00 12. Library Fee Rs. 200.00 13. Students Aid Fund Rs. 25.00 14. Utility Fee (one-time) Rs. 1000.00 * Only for students from institutions other than Berhampur University. Fee once collected at the time of admission shall not be refunded under any circumstance. 7

NB: For Three Year Executive MBA students, the University shall not arrange any transport facilities and the students are to make their own arrangements for their conveyance. However, the University may arrange transport facilities for these students, subject to availability of private transport, on payment of requisite fee by the students as fixed by the University from time-to-time. The transport charges may be enhanced depending on the increase in POL (fuel) and maintenance charges. In case no transport operator agrees to provide transport, then the students have to make their own arrangements for their conveyance. (D) Seminar Fee: The students shall have to pay seminar fee and any other fee to the Department/ Centre as decided by the concerned Course Coordinator. XV. ADMISSION OF FOREIGN STUDENTS Fifteen percent supernumerary seats may be created in all the above courses for admission of foreign students. These seats shall be exclusively meant for foreign students. No candidate from a foreign country will be considered for admission unless his/her case has been sponsored by the relevant Department/Ministry, Government of India. The sponsored candidates will be required to submit in the prescribed proforma a Medical Fitness Certificate from a Registered Medical Practitioner not below the rank of CDMO within a month of their provisional admission, besides such other documents as are required under the rules/instructions of the Government of India/Odisha. Foreign students who have passed the qualifying examination from a foreign country taking admission in the courses have to pay Rs. 10,000/- (Rupees ten thousand) only more along with other fees for the entire course. XVI. HOSTEL FACILITIES: Hostel facilities will be provided to the students of self-financing courses, subject to availability of seats in the P.G. Hostels for Boys and Girls. In the event of allotment of hostel seats the students shall have to abide by the Rules and Regulations of the Hostel and pay the requisite fees at par with the regular students. XVII. COMMENCEMENT OF CLASSES Classes of the different courses will commence on the date and time to be notified by the respective Course Coordinators. Normally the classes will be held during morning and evening hours or as decided by the Course Coordinators of the respective courses. XVIII. The University reserves the right to conduct or cancel any course, if adequate number of students are not admitted/ registered due to some reason or other. XVIX. DISPUTES All disputes concerning admission and studentship are subject to the exclusive jurisdiction of the Civil Courts and legal forums at Berhampur (Ganjam). All admissions are provisional and can be cancelled at any time for any valid reason such as misconduct, forgery, etc. XX. RAGGING Ragging in any form is strictly prohibited. Severe action shall be taken as per rules against those involved in ragging. As per the U.G.C guide line 6.1 (d & e) of the regulation (F-1-16/2007 (CPP II/dated 17 June 2009), it is mandatory for all the applicants to submit an affidavit in a non-judicial stamp paper as per the prescribed proforma enclosed in the prospectus, if admitted. 8 CHAIRMAN, P.G. COUNCIL Berhampur University

Index No. Date of Receipt APPLICATION FORM FOR ADMISSION INTO SELF-FINANCING COURSES BERHAMPUR UNIVERSITY ACADEMIC SESSION 2015-16 Application for Admission into. (Mention the name of the Course) 1. Name of the Applicant (As in the HSC Certificate) (In BLOCK LETTERS) 2. (a) Sex : Male / Female (b) Nationality : 3. Date of Birth : Day Month Year 4. Father s / Guardian s Name : 5. Mother s Name : 6. (a) Permanent Address (in detail) : Paste Recent Colour Passport size Photograph duly attested at the front (b) Present address for correspondence (in BLOCK LETTERS & in detail) : Parent s Tel. No. Mobile No. e-mail: Applicant s Tel. No. Mobile No. e-mail: 7. Berhampur University Regn. No (For students of Berhampur University): 8. Mention if admission is claimed from Reserved Quota (Please whichever is applicable and Submit attested copy of reserved quota certificate) SC/ST 9. (a) Qualifying Degree Examination Passed / Appeared : (b) Specify the subjects taken at the Degree level indicating HONOURS subject, if any. : (c) Name of the University/Institution from which passed/appeared : (d) Entrance Fee: Bank Draft / e-receipt No., Date and Amount : 9

10. EDUCATIONAL QUALIFICATIONS Name of the Examination University/ Council/Board Year Divn. & Distn. Marks secured Maximum marks Remarks (a) H.S.C. or equivalent (b) Intermediate/+2/Diploma/D.Pharm. (c) B.A/ B.Sc./ B.Com. /B.E.S./ B.E/ B.Tech./BBA/BCA/BIT/B.Pharma (d) Post-Graduation (e)any other / experience Note: Candidates are required to submit self-attested copies of mark sheets (year-wise) and certificates of all the above examinations. 11. Declaration/Undertaking: I declare that the particulars furnished in this form are true to the best of my knowledge and belief and as per my certificates and valid official documents. I further declare that in case any of the above information is found to be incorrect at any time, I shall be liable to forfeit my seat and to such penal action as the University may deem appropriate. I undertake to abide by the rules of the P.G. Council and P.G. Hostels, framed by the Berhampur University and if at any time instance of breach of these rules, indiscipline, disobedience or misconduct or involvement in ragging is found against me, my name shall be struck off from the rolls of the University. I have understood the various provisions and rules of eligibility and admission to various Self- Financing Courses of P.G. Departments of Berhampur University as mentioned in the Prospectus supplied to me along with the application form and I undertake to abide by any decision taken by the University authorities in regard to my eligibility and admission into P.G. Departments. Date:. Check List of Enclosures: Full Signature of the Applicant The application should be accompanied by the following documents. 1. Two recent self- attested passport size colour photographs. 2. Self attested copies of mark sheets and certificates of all the examinations passed (HSC or equivalent, Intermediate/+2, B.A./B.Sc./B.Com./B.E.S./B.E./B.Tech./BBA/BCA/BIT/+3 Degree/B.Pharma/P.G. Degree etc.). Candidates should submit copies of the mark sheets of 1 st year, 2 nd year and final year examinations of the +3 Degree course/ all semesters of qualifying degree. 3. Duly filled-in prescribed Affidavits (Annexure-I and II) in non-judicial stamp paper in original are to be submitted in case you are admitted. 4. Declaration as specified in the application form. 5. Two self addressed envelopes (22 cm x 10 cm). 6. Self attested copy of Registration Receipt (for Berhampur University candidates). 7. Bank Draft/e-receipt in original for the amount as stipulated at provision VI of the Prospectus towards Entrance Fee. 8. Duly filled-in student ID Card Format 9. Applicants interested for accommodation in the University Hostels are to submit an application in plain paper to the Course Coordinator along with the application. Note: Application incomplete in any respect is liable to be summarily rejected. Further, applications which do not confirm to the prescribed on-line or PDF form will also be summarily rejected. 10

ANNEXURE I AFFIDAVIT BY THE STUDENT I, (full name of student with admission/registration/enrolment number) s/o d/o Mr./Mrs./Ms.., having been admitted to..(name of the institution), have received a copy of the UGC Regulations on Curbing the Menace of Ragging in Higher Educational Institutions, 2009, (hereinafter called the Regulations ) carefully read and fully understood the provisions contained in the said Regulations. 2. I have, in particular, perused clause 3 of the Regulations and am aware as to what constitutes ragging. 3. I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am fully aware of the penal and administrative action that is liable to be taken against me in case I am found guilty of or abetting ragging, actively or passively, or being part of a conspiracy to promote ragging. 4. I hereby solemnly aver and undertake that a) I will not indulge in any behaviour or act that may be constituted as ragging under clause 3 of the Regulations. b) I will not participate in or abet or propagate through any act of commission or omission that may be constituted as ragging under clause 3 of the Regulations. 5. I hereby affirm that, if found guilty of ragging, I am liable for punishment according to clause 9.1 of the Regulations, without prejudice to any other criminal action that may be taken against me under any penal law or any law for the time being in force. 6. I hereby declare that I have not been expelled or debarred from admission in any institution in the country on account of being found guilty of, abetting or being part of a conspiracy to promote, ragging; and further affirm that, in case the declaration is found to be untrue, I am aware that my admission is liable to be cancelled. Declared this day of month of year. Signature of deponent Name: VERIFICATION Verified that the contents of this affidavit are true to the best of my knowledge and no part of the affidavit is false and nothing has been concealed or misstated therein. Verified at.(place) on this the.(day) of..(month),. (year). Signature of deponent Solemnly affirmed and signed in my presence on this the (day) of.(month), (year ) after reading the contents of this affidavit. 11 OATH COMMISSIONER

ANNEXURE - II AFFIDAVIT BY PARENT/GUARDIAN I, Mr./Mrs./Ms. (full name of parent/guardian) father/mother/guardian of.. (full name of student with admission/registration/enrolment number), having been admitted to.. (name of the institution), have received a copy of the UGC Regulations on Curbing the Menace of Ragging in Higher Educational Institutions, 2009, (hereinafter called the Regulations ), carefully read and fully understood the provisions contained in the said Regulations. 2. I have, in particular, perused clause 3 of the Regulations and am aware as to what constitutes ragging. 3. I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am fully aware of the penal and administrative action that is liable to be taken against my ward in case he/she is found guilty of or abetting ragging, actively or passively, or being part of a conspiracy to promote ragging. 4. I hereby solemnly aver and undertake that a) My ward will not indulge in any behaviour or act that may be constituted as ragging under clause 3 of the Regulations. b) My ward will not participate in or abet or propagate through any act of commission or omission that may be constituted as ragging under clause 3 of the Regulations. 5. I hereby affirm that, if found guilty of ragging, my ward is liable for punishment according to clause 9.1 of the Regulations, without prejudice to any other criminal action that may be taken against my ward under any penal law or any law for the time being in force. 6. I hereby declare that my ward has not been expelled or debarred from admission in any institution in the country on account of being found guilty of, abetting or being part of a conspiracy to promote, ragging; and further affirm that, in case the declaration is found to be untrue, the admission of my ward is liable to be cancelled. Declared this day of month of year. Signature of deponent Name: Address: Telephone/Mobile No.: VERIFICATION Verified that the contents of this affidavit are true to the best of my knowledge and no part of the affidavit is false and nothing has been concealed or misstated therein. Verified at..(place) on this the..(day) of.(month), (year ). Signature of deponent Solemnly affirmed and signed in my presence on this the (day) of (month),. (year ) after reading the contents of this affidavit. 12 OATH COMMISSIONER

DECLARATION (To be submitted along with the application form) 1. I Mr/Ms.. do hereby declare that I am aware of the provision that students admitted to the Executive MBA, MBA (Financial Management) and M.Tech. (Environmental Science) courses are not permitted to take concurrent admission in any other course(s) or appear at any other examination so long as they continue their studies in the concerned courses, and until they have fully appeared at the said examinations. 2. I do hereby declare that I have not been admitted to any other course(s) nor shall I appear at any other examination as long as I continue my studies in the course, if admitted. 3. If at any time it is found that I have violated the above conditions, I shall be liable to forfeit my seat, cancellation of my admission and such other penal action as may be considered appropriate by the University. I shall not claim the refund of the course fee and other fee deposited at the time of admission. 4. I shall abide by the rules and regulations of self-financing courses of Berhampur University Date: Full Signature of the Candidate 13

INDEX (Address to be filled in by the Candidate) Affix Rs.6/- Postage Name : Place : P.O. : District: State. Pin Code:. BERHAMPUR UNIVERSITY FOR ADMISSION TO COURSE, 2015-16 Index No... Date.. The undersigned acknowledges the receipt of your application for admission. You are required to quote the above Index Number in all correspondence regarding your admission. Course Coordinator 14

BERHAMPUR UNIVERSITY BHANJA BIHAR, BERHAMPUR- 760007, GANJAM( ODISHA) ADMIT CARD FOR ENTRANCE TEST 2015-16 Paste Recent Colour Passport size Photograph duly attested at the front ( Particulars to be filled in by the candidate in his / her own hand writing only) NAME:----------------------------------------------------------------------------------------- ROLL NUMBER:---------------------------------------------------------------------------- SUBJECT:------------------------------------------------------------------------------------ CENTRE OF TEST:-------------------------------------------------------------------------- SIGNATURE OF THE CANDIDATE IN FULL:--------------------------------------------- COURSE COORDINATOR NB: Candidates shall not be allowed to enter into the examination hall after 30 minutes of commencement of entrance test, and are not allowed to carry any incrementing material including mobiles, pagers or any other document/ electronic gadget. 15

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