Date of Regn. : Appln. No. M.O.P. VAISHNAV COLLEGE FOR WOMEN (AUTONOMOUS) No.20, IV LANE, NUNGAMBAKKAM HIGH ROAD, CHENNAI - 600 034. Website : www.mopvc.edu.in APPLICATION FOR ADMISSION M.A. (Broadcast Communication) 2015 - 2016 (Semester Pattern) 1. Name of the Applicant : [BLOCK LETTERS] English : (As in U.G Mark Sheet) Tamil : 2. Date of Birth : 5. Community : 3. Religion : 6. Community Name : 4. Nationality : 7. Mother Tongue : 8. Name of the Parent / Guardian : 9. Address for Communication : OC BC MBC / DNC SC / ST 10.Occupation of the Parent : Designation : Door No. / Street __________________ Area / District ____________________ Name of the Organisation / Company : Office Address : State _______________ PIN ________ Mobile Phone No. Telephone No. : E-mail Id : Mobile Phone No. : 11. Annual Income of the Family : 12. Tick the appropriate box 13. Daughter of Ex-serviceman Tamil Origin from of Tamil Nadu origin Andaman and Nicobar Physically Handicapped (a) Name of the Qualifying Exam : (b) Name of the College and University : (c) Year & Month of Passing : (d) Marks Secured & class obtained (Enclose Photocopies of Marksheets) : 14. Mention Additional Courses / Examinations Qualified if any : 15. Work Experience if any : 16. Mention achievements in Co-curricular / Extra curricular Activities : 17. If old Student of the College, State Branch and Roll No. : Sports / NCC / NSS M.O.P. Vaishnav College for Women ( Autonomous), Chennai - 34. No. : Website : www.mopvc.edu.in 2833 0262 Acknowledgement Received Application Form for M.A. (Broadcast Communication) 2015 - 2016 course. This is only an acknowledgement of registration of application and not an offer of seat. Group Discussion & Interview Date : 4th June 2015 Time : 9.30 a.m. 18. Details of Qualifying Examination Passed : Graduates from Engineering and Autonomous Colleges - enclose attested copies of Mark Sheets English & Language not to be included in total. Year Subjects Year & Month of Passing Marks Obtained I Total - A II Total - B III Total - C Grand Total (A+B+C) % Obtained Attesting Officer’s (Gazetted Officer / Head of the Institution) Name : Designation : Signature with Seal : I declare that all the particulars furnished above are true and correct. I submit that I will abide by the rules and regulations of the College. Signature of the Parent / Guardian Name & Signature of the Applicant Station : Date : Note : Students who are yet to receive the final year results are asked to enclose Xerox copies of I and II Year Mark Lists.
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