THE GLOBAL OPEN UNIVERSITY, NAGALAND eae tae re ea Se sare Soom ee eae oe eee a RECOGNISED BY THE UNIVERSITY GRANTS COMMISSION (UGC) ian. ee a ox ADMISSION FORM FOR SUBSIDISED LOW FEE COURSES Roll, Number Date CHOICE FOR THE COURSE : ‘Degree Course out oft Listanven onthe ngnthong ste Choice for the Examination Centre. Tia eae ene Sab (Annual Examinations are conducted in June and December every year) EXAMINATION CENTRES Agni, Azo Atanas Apecnbed Siang. Age Air, Abia. Batiy, Bangers thoy usenesrer Sia bar, dar. Grengnm Canes Ctra betacin Ox, Denour Ons, Coa FRahtem Song Simi Sanpanagr Saga Sagar Sas Tend, Taamgur dnp Varese Name of the Applicant (IN CAPITAL LETTERS) Fathers / Husband's Name (IN CAPITAL LETTERS) Address for Correspondence State Pincode, Phone (omice) Phone (Residence) Nationality Date of Birth Sex: Male / Female Ema, Educational Qualifications : Attach photocopies of certificates / marks-sheets ‘ramination University / Board Institution Year__Dwison Details of Experience (ifany), Details of Fees Paid Re. by Bank Dratt No Dated, Drevin on (lame othe Bank) Permanent Adaress and Phone Number of tre Applicant Date Place Signature of the Applicant The Gaba Opan Unholy. Nagaland hasbeen ecabichody he Govarnies of Nagalndundor Pe provers 2t The Gcbal Open Unvoety Nagaland Act 2006 (Act 3.0? 2008) The Gobal Open University, Nagaland Ie Srpoweredo avord Degrovs 2s dened under Sector 22 of te Uriverety Grants Cormlclen Act 1886