THE ENGLISH AND FOREIGN LANGUAGES UNIVERSITY HYDERABAD - 500 007

Application for Admissions 2013-14 Application No. : 13064881. Name of the candidate : Thara Mohan2. Date of Birth : 09-12-19903. Name of the father : N Mohanan4. Name of the mother : K P Kallianikutty5. Present Address : Address - Thara Mohan, Puthenveettil House, Kuttumukku,, Ramavarmapuram

P.O. City - Thrissur Pincode - 680631 State - KERALA

6. Permanent Address : Address - Thara Mohan, Puthenveettil House, Kuttumukku,,Ramavarmapuram P.O. City - Thrissur Pincode - 680631 State - KERALA

7. Tele No with STD code : 04872337783 8. Mobile No. : 9949077594 9. E-mail : tharamhn@gmail.com10. State of Domicile : Kerala11. Category : General12. Ward of Defence Personnel (Y/N) : : NO 13. Displaced Kashmiri Migrant : NO14. PWD (Visually/Physically Challenged persons) : NO PWD Type : -- 15. Programme Name : Ph D 16. Subject : Translation Studies 17. Subject preference 1 : Subject preference 2 : 18. Test Centre 1st Preference : Kochi Test Centre 2nd Preference : Bengaluru 19. Name of the Campus : HYDERABAD20. Position regarding qualifying exam : RA21. Do you belong to any minority community (forstatistical purpose only) : NO22. Payment DetailMode of Payment : State Bank of India ChallanDD/Challan Journal No. : 035872533 Date : 2013-05-02Bank : State Bank of India Branch : Lallaguda Amount : 350.00

23. Academic record from SSC (X standard) onwards (Enclose copies of certificates)Examination Passed /

CourseName of the Board

/Univ Subjects Taken Year of PassingTotal Marks

Max. Marks MarksObtained % of MarksX CBSE English Science

Social Studies MathsSanskrit

Mar-2006500 456 91.2

XII CBSE Maths EnglishPhysics ChemistryComputer

Mar-2008500 415 83

English Hons. EFL University Apr-2011 5/624. Is there any gap in your studies? :

1/3

25. If applying for Ph.D. programmesa) mention topic of research. (Submit TEN copies of the research proposal in the stipulated format at the time of the interview) :b) Have you passed the UGC JRF NET? : --26. Do you require Hostel Accommodation? :YES27. Have you ever been subjected to disciplinary action by any authority? :NO If yes, give details : 28. Any other information such as publications/excellence in sports/music, etc.( attach separate sheet if needed) Please specify : 29.a) Have you done an M.Phil./M.Litt. degree from CIEFL/EFL University? :N30. DECLARATION BY THE APPLICANT: I hereby declare that all the information furnished by me in this application and in thedocuments I have submitted in support of my application is true, complete and correct. In case any information in this application isfound to be false or incorrect at any time (during or after completion of the course), it shall entail automatic cancellation of myadmission if granted, cancellation of the degree if awarded, besides rendering me liable to such action as the University may deem fit. In the event of any medical or other emergency, my parent/s or guardian may be contacted at the address given below.Place:Date:

Affix your recent passport size colourphotograph duly attested by a

Gezetted officer.

31. DECLARATION BY FATHER/MOTHER/GUARDIAN: My daughter/son/ward Mr./Ms. Thara Mohan is applying for admission to theEFL University. In case of her/his admission to the University, I shall be responsible for payment of all her/his fees and other chargesincluding medical insurance. Should there be any medical emergency, I shall be responsible for the payment of all such medicalexpenses that may not be covered by medical insurance. In case any information in this application is found to be false or incorrect atany time (during or after completion of the course), it shall entail automatic cancellation of my daughters/sons/wards admission ifgranted, cancellation of the degree if awarded, besides rendering her/him liable to such action as the University may deem fit. I will also be responsible for her/his good conduct and behaviour during the period of her/his stay in the University. Further, I may becontacted in the event of any emergency as determined by the University and I hereby promise that I will make myself present beforethe University authority at my own cost whenever the University requires my presence.Fathers Occupation : Doctor Annual income Rs : 200000 Mothers Occupation : Doctor Annual income Rs :200000

Signature of the Parent/GuardianPlace: Full Name:Date: Relationship with the applicant: Note: Signature of the parent/guardian in this application form will be considered the basis for all verification purposes in theUniversity.Checklist of Enclosures: 1. Date of Birth Certificate (SSC / X Class Standard certificate)2. Intermediate Certificate and Marks memo (for B.A.(Hons.) programmes)3. Degree Certificate (provisional Certificate in case the Degree Certificate has not been issued)4. Degree Examination Marks Memo(s)

2/3

5. Masters degree/Provisional Certificate6. Masters degree Marks Memos7. Community and Income Certificate (in the case of SC/ST candidates - issued by Competent Authority)8. Non-Creamy Layer Certificate for OBC candidates in GOI proforma9. Medical Certificate from a Civil Surgeon (in case of PHC/VHC candidates)

3/3