Results 2009 Application Icet 2009

APPLICATION No.:

APPLICATION FORM FOR

ICET - 2009

H.T. No. :

INTEGRATED COMMON ENTRANCE TEST (ICET) FOR ADMISSION INTO MBA/MCA COURSE (FT/PT/EVENING/DISTANCE MODE) OF ALL UNIVERSITIES IN ANDHRA PRADESH AND THEIR AFFILIATED COLLEGES Last date for receipt of filled-in application by the Convener : On or before 28.03.2009 up to 5.00 p.m. With a late fee of Rs.500-00: On or before 10.04.2009 up to 5.00 p.m. With a late fee of Rs2,000-00: On or before 17.04.2009 up to 5.00 p.m.

PHOTO

INSTRUCTIONS: 1.The candidate should fill in the form in his/her own handwriting; 2. The Convener, ICET-2009 reserves the right to reject the application of the candidate at any stage if :a) The application is incomplete/filled by others, b)The application is not signed and attested by a Gazetted Officer/ Principal of a college/a university Professor, c)The candidate fails satisfy the eligibility conditions. d) Any false or incorrect information is furnished, e) The entries in the application form are illegible. f)The application is received after the last date and time specified. 3.Cost of application form is not refundable under any circumstance.; 4.Change in the entries of caste/community/status of category and examination centre in the application form will not be permitted once it is received at the office of the Convener. 5. The passport size photograph on the application form and computerized ICR Summary Sheet must be identical and taken on or after 1st January, 2009. 6. The original Hall Ticket will be sent only by post and will not be issued to the candidate in person. The Convener will not be held responsible for its non-receipt or postal delay of the Hall Ticket. Candidates are required to affix postal stamps on the envelopes. 7.The photos should only be PASTED on application form and ICR Summary Sheet Pinning/Stapling is not accepted.

1. Name of the applicant in full (IN BLOCK LETTERS as per SSC/ Xth Class Marks Memo/Certificate)

:

2. Father’s Name

:

3. Address for Communication (IN BLOCK LETTERS)

:

Surname Name

PIN : Telephone:

STD

Mobile:

Number

Email: 4. Date of Birth (Enclose attested Certificate)

DAY

MONTH

YEAR

: 2.

5. Identification Marks: 1. 6. Choice of Regional Centre for Entrance Test in the order of preference: (Refer to Item No. 4 of instructions booklet)

1. Code:

Place: ______________________________

2. Code:

Place: ______________________________

7. Do you claim reservation under any one or more of the following categories? If so, put tick (9) mark in the appropriate box (in case of SC, ST and BC candidates, latest caste certificate, duly attested, must enclosed) SC 8. Do you belong to EBC?

ST

BC-A

Yes

BC-C

BC-D

BC-E

NCC

SPORTS

PH

CAP

No

9. Total Annual parental income: Rs. 10. Local Area : AU (Tick the name of the Area University to which you are local) 12. Details of qualifying examination:

BC-B

OU Area

Passed

SVU Area

Non Local

11. Do you have mathematics at 10+2/Degree? Yes No

Appearing

(Tick (9) whichever is applicable)

Name of the Qualifying Examination (put tick (9) mark) in the appropriate box B.A. B.Sc. B.Com. B.B.M. B.E./B.Tech B.L./LLB BCA

13. Do you belong to any minority community? (put tick (9) whichever is applicable)

Year of passing/ % of appearing Marks

University

Any other (specify)

Muslim Christian Any other minority

I hereby solemnly affirm that I have filled in all the particulars and information in this application form in my own handwriting and that they are true. I have carefully gone through the instructions booklet, and have become fully conversant with the eligibility conditions to be satisfied for appearing at the Entrance Test. I fully realize that the issue of the Hall Ticket for the entrance test and securing the rank do not absolve me of the responsibility of satisfying the eligibility criteria for the entrance test. Place: Date : (Signature of the Applicant)