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SC ST OBC GENERAL KARNATAKA STATE OPEN UNIVERSITY MUKTHAGANGOTRI, MYSORE-570 006 In Collaborat ion with algol universal trust Distance Mode Face to Face Mode Programmes 2014-2015 Appl No. Application For Admission To ........................................ ........................................ Study Centre Name :.................................Study Centre Admission Cycle: 1st Cycle July 2nd Cyc le January Roll Number : STUDENT S PERSONAL INFORMATI ON ( PLEASE FI LL IN BLOCK LETTERS) 1. Name :....................................... ........................................ ........................................ .. 2. Father/Husband Name :....................................... ........................................ ............................. 3.

SC ST OBC GENERAL . KARNATAKA STATE OPEN UNIVERSITY MUKTHAGANGOTRI, MYSORE-570 006 . In Collaboration with . Algol Universal Trust . Distance Mode Face to Face Mode Programmes 2014-2015

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