UNIVERSITY OF KERALA www.keralauniversity.edu APPLICATION FOR REGISTRATION AS A MATRICULATE (FOR PRIVATE CANDIDATES ONLY) Pay-n slip/ D.D.No.-------------------------------Amount Rs. ------Date of payment--------------Name of Bank in the case of D.D.--------------(D.D. to be drawn in favour of Finance Officer 1. (a) Name (as entered in the S.S.L.C. or other qualifying certificate) (b) Name in Block letters (to be given within brackets) 2. Name of father or guardian 3. Age and date of birth as entered in the S.S.L.C. or equivalent certificate (in Christian Era) 4. Religion and Community 5. Mother tongue 6. (a) School where educated (b) Register number and year of S.S.L.C or other qualifying certificate (c) Authority issuing such certificate 7. College or other Institution in which the applicant last studied and the date of admission in Christian Era 8. Course for which he/she is studying in Kerala University 9. Institution in which he/she is studying 10. Signature of the Applicant 11. The above details have been verified with the original documents and found correct Signature: Designation University Pay in slip/D.D. for Registration as a Matriculate Rs.50/- should be sent with this application A fine of Rs.50/- shall be received for late application. *This column should be countersigned by the Principal of a College or a Gazetted Officer.
