Form Price Rs. 50/- (lncluding Syllabus)

APPLICATION FOR ADMISSION TO THEGOVERNMENT DIPLOMA IN CO.OPERATION AND ACCOUNTANCY EXAMINATION

IMP : Please read carefully the "lnstructions to the Candidates" before filling in theapplication form.

To,

The Secretary,Government Diploma in Co-operation and Accountancy Board,C/o. Commissioner for Co-operation andRegistrar, Co-operative Societies, Maharashtra State,Central Building Annexe, 2nd Floor, Pune-411 001.

(Through the District Deputy Registrar, Co-operative Societies)(fu€r sqP{*ero, wr*.rft r{wn qiffia ord qrdq,r}f,.)

Sir, .

I would like to appear for the ensuing G. D. C. &A.

1. Narne of the Applicant (in BLOCK LETTERS) .

Nq 1S?85

Examination to be held in May 2412

lndentity Card Size Photoaffix here

Surname SHRI./ SMT./ KUM.

Name

Father's / Husband's Name

(Name in Devnagari Script) aft.l *ftrr*

2. Address (in BLOCK LETTERS) with Pin Code Number. (Leave one box blank after each complete word.)

PIN MOBILE NUMBER

3. Educational Qualifications (Please enclose attested true copies of certificates, tl e. B. A. / B. Com. / B. Sc. etc.)

Last Examination Passed Name of the Board / University / lnstitution who

. conducted the ExaminationYear of Passing

4. Experience (Please enclose attested true copies of certificates for Departmental Candidate/Co-operative lnstitutional Candidate)

Post held Name of Employer Period of Service

5. Details of Exemptions in G. D. C. & A. Examination : Candidates securing 50 and above marks in asubject can only avail exemption in that paper. ( Please attach attested Xerox Copy of Mark Sheet )

Co-operative Law & Other Laws

2

7. Details of the fee Rs. 500/- Paid

(a) Challan No.

(c) Name of the Treasury/

Bank Branch

Year

(bl Date

8. Declaration : I have read the rules and regulations of the examination and I promise to abide by them.The above particulars are true to the best of my knowledge.

For Office use only

G

U

D

o

9. Qualification Code :

10. Employees Gode :

Graduate:

Under Graduate :

Departmental:

lnstitutional :

Others:

Paper No. I Theory & History of Co-operation 1

Paper No. lll Co-operative Law& Other Laws 3

Paper No. V Co-operative Audit 5

Column No. 7 : The head of account to whichGovernment Treasury is as follows :

0425 - CO-OPERATION,8OO_OTHER RECEIPTS.(IX)-EXAMINATION FEES

' (04250125)

Yours faithfully

Signature of Candidate

Paper No. ll Co-operative Management 2

Paper No. lV Accounts 4

Paper No. Vl Banking 6

G. D. G. & A. Examination : lnstructions to Gandidates

Most lmportant : Please read carefully the following instructions before filling in the application form. lt is for yourbenefit, as the information is to be processed on computer.

1. lncomplete application forms are liable to be categorically rejected and no further correspondence in thatrespect shall be entertained by the Board.

2. Cotumn No. I : Write your name in BLOCK LETTERS ONLY. Do not use prefix such as Shri./Smt./Ms./Mrs./Mr. etc. Also give your full name in Devnagari Script in the space provided.

3. Column No. 2 : Give your complete permanent address along with Pin Code Number and Mobile Phone Number.

lncorrect and incomplete address may lead to delay in correspondence.

4. Column Nos. 3 & 4 : DO NOT SUBMITANY ORIGINAL CERTIFICATE. Attach certified copies only attested byGazetted Officer / Principal of recognised College / Headmaster of recognised Junior College or High Schools.

5. Golumn No. 5 :' lt is important that the details of the claims for exemption from appearing for various subjects be

entered correctly in to this column. The candidates are requested to note that NO CLAIMS FOR'EXEMPTION FROM APPEARING AT ANY PARTICULAR SUBJECT/S SHALL BE CONSIDEREDUNLESS THE DETAILS ARE FURNISHED lN COLUMN No. 5.

SUBJECT CODE

6. Column No. 6 : Ensure that the name of the centre and its corresponding code number are entered into legiblyand correctly.

CENTRE CODE

01 MUMBAI 02 THANE ffi NASHIK 08 JALGAON

09 AHMEDNAGAR 10 PUNE 11 SOLAPUR 12 SATARA

13 SANGLI 14 KOLHAPUR 15 AURANGABAD 21 LATUR

23 AKOLA 24 AMRAVATI 27 NAGPUR 29 CHANDRAPUR

the Examination fees should be credited in the