DAMODARAM SANJIVAYYA NATIONAL LAW UNIVERSITY Ph: 0891-2529952, Fax: 2502308 Regd. No (For Office use only) Last Date for Receipt of Filled in Form : 06-06-2015 Note 1: All applications/correspondence should be addressed to the Registrar at the above address. Note 2: Candidates are advised to go through the Regulations, fee structure and other details placed in the University website carefully. APPLICATION FORM ADMISSION INTO 4 YEAR LL.B.,LL.M.(Dual Degree) Academic Year- 2015-16 1. Name of the Applicant (as per SSC certificate): (in capital letters) 2. Date of Birth : DD MM YY Paste Recent Self Attested Passport size 3. Male Female 4. Address for correspondence: (Please give details of State/phone/cell/email) (Any change in the address may please be intimated immediately.) State:..Pin:.. 5. Place of Birth:. 6. State:. 7. Nationality:.. 8. Religion: 9. Student Cell No:... 10. Email Id:.. 11. Reservation Category: (enclose attested copies of latest Certificates) OBC SC ST A B C D E DAP NCC Sports CAP DAP: Differently Abled Person, CAP: Children of Armed Personnel 1
12. Details of Qualifying Examination (Enclose attested copies of Memoranda of Marks) Examination 10 th Std. Year of Passing Name of College / School Board Max. Marks Marks Obtained % of Marks. 10+2 Under Graduate Any Other 13. Local candidate of : (i) Andhra University Area (Enclose proof) (ii) Osmania University Area (III) Sri Venkateswara University Area (iv) Other State (v) Foreign 14. Details of Parents: Name of the Father/Mother/Guardian.. Occupation & Designation :. Address :.... Phone :...Mobile:.. Email:.. Annual Income (enclose proof) : Rs (in figures & words) 15. Whether required Hostel Accommodation for the Academic Year 2015-16: Yes No 16. Particulars of Fee : Amount D.D. No. Date Bank.. D.D drawn in favor of 2
DECLARATION BY THE CANDIDATE I fulfill all the eligibility conditions as laid down in the regulations. I have not been debarred from taking admission in any educational institution in India. If admitted I will abide by the disciplinary and other rules and regulations of Damodaram Sanjivayya National Law University, Visakhapatnam, framed and enforced from time to time. I promise not to indulge in ragging or other undesirable activities against University norms or prejudicial to the interest of the University which will attract disciplinary action. The information furnished by me in the application form is true to the best of my knowledge and belief. Place : Date : Signature of Candidate DECLARATION BY THE PARENT I declare that the particulars furnished by my son/daughter/ward in this application form are correct & true to the best of my knowledge. I undertake and bind myself to pay on behalf of my son/daughter/ward such fees, charges etc., which Damodaram Sanjivayya National Law University may levy from time to time. In the event of failure on my part and / or on the part of my son/daughter/ward in this regard, the Registrar, Damodaram Sanjivayya National Law University may take such action against my son/daughter/ward as he may deem fit and necessary. I also undertake to ensure his/her good conduct. Place : Date : Signature of the Parent 3
List of Enclosures: (enclose Xerox copies only). 1. Proof of Age 2. Marks statement of X Standard, Marks statement of XII Standard / Intermediate or Equivalent / UG from any recognized University. 3. T.C. & C.C. issued by the Head of the Institution last studied. 4. Latest Caste Certificate/Income Certificate/Disability Certificate in case of SC / ST / BC / Differently Abled Person. 5. Local Candidate Certificate 6. Self addressed envelope. 7. One passport size photograph 8. The filled in application form along with a fee of Rs. 2000/- (Rupees two thousand only) by Demand Draft drawn on any nationalized bank, in favour of Registrar, Damodaram Sanjivayya National Law University payable at Visakhapatnam. *All the above Original Certificates should be produced at the time of Counseling. Note : Incomplete application forms shall be rejected and no further correspondence with regard to rejection of application shall be entertained. Any concealment of material facts or furnishing wrong information will lead to cancellation of admission / appropriate legal action at any time. The University reserves the right to cancel the admission of any candidate who indulges in any act of ragging / indiscipline / guilty of misconduct during the course of study at Damodaram Sanjivayya National Law University. Application form should be only on A4 size paper and printed on one side only. Any dispute arising out of the programme is subject to the jurisdiction of Courts in Visakhapatnam only. Important Dates: Last Date for Receipt of Filled in Application Form : 06-06-2015 Date of Screening Test / Group Discussion : 21-06-2015 Date of Counseling : 04-07-2015 Commencement of Classes for the academic year 2015-16 : 13-07-2015 4
DAMODARAM SANJIVAYYA NATIONAL LAW UNIVERSITY (Candidate Copy) DAMODARAM SANJIVAYYA NATIONAL LAW UNIVERSITY (Office Copy) DAMODARAM SANJIVAYYA NATIONAL LAW UNIVERSITY (Examination Centre Copy) 5