Martin Luther Christian University Nongrah, Dongktieh, Block 1, Lower Nongrah, Shillong-793006, Meghalaya. Website: www.mlcuniv.in Ph: +91-8974068427; Fax: 0364-2506489; E-mail: [email protected] The Light of Truth 2014-2015 Academic Year Please tick the appropriate box Medical & Health Sciences Management & Commerce Passport BSc MLT MSc MLT (M/CB) BBA M Com photograph BSc ST MSc MLT BTA MTA BSc MIT MSc ST MBA (HR/Mktg /Finance) B Opt MSc MIT MAMDP (Self Study) BSc PhA M Opt BSc CHP MSc N&D BSc F&N MANH BA NH Social & Behavioral Sciences Computer Sciences Arts and Humanities BSc Psy MSc CP DCA BA Music BSW MSW BCA BSc HNT MA Music M Phil CMH PGDCA MCA PGDPS (Self Study) Environment & Traditional Ecosystems MAESD FOR OFFICE USE If you have more than one choice, please indicate order of preference 1. ___________________________________ 2. ___________________________________ 3. ___________________________________ ________________________________________ Full Name (in block letters): ____________________________________________________________________ Present Address: ____________________________________________________________________________ _________________City: ____________________ State: ____________________ Pin Code: ________________ Permanent Address: _________________________________________________________________________ _________________City: ____________________ State: ____________________ Pin Code: ________________ Contacts: Landline_______________ Mobile: +91-__________________ E-mail ______________@__________ Date of Birth: ________________________ Place of Birth: City: __________________ State _______________ Sex: Male Female Country of Birth: ___________Nationality:__________ Category:ST/SC/OBC/General Father’s / Mother’s Name: _____________________________________________________________________ Address: ____________________________________________________________________________________ Profession: __________________ E-mail: _______________@_________ Contact No: +91-_________________ Local Guardian’s Name: _______________________________________ Relationship: ____________________ Address of Local Guardian:________________________________________________________________ Contact No: ___________________________ E-mail Address: ___________________@____________________ Educational Qualifications: Board / University Institution Year of Passing Exam Passed Class / Division Signature of Student: __________________________ Signature of Parent/Guardian: ______________________ Date: __________________ Date: __________________ Please submit completed application form to the Registrar, Martin Luther Christian University, Nongrah, Dongktieh, Block 1, Lower Nongrah, Shillong-793006, Meghalaya. Ph No.08974068427. E-mail: [email protected] Checklist of enclosure: (Attested Photocopies only – please DO NOT submit originals) 1. Mark list/transcript of Class X, Class XII and Graduation marksheets of all semesters/years whichever applicable. 2. SC/ST/OBC certificate 3. 4. 5. 6. 7. Birth Certificate or an examination certificate showing date of birth Transfer Certificate for UG/ Migration certificate for PG Courses. Candidates applying for advance standing to a UG/PG course:- i. should provide mark sheets for each semester/year; ii. should provide a no objection certificate for UG/PG from the institution last attended. 1 colour passport size photographs Application fee of Rs 500/- by cash / crossed DD in favour of “Martin Luther Christian University” payable at Shillong. LAST DATE OF FORM SUBMISSION: Undergraduate and Postgraduate courses: July 25, 2014. Courses: Medical & Health Sciences Bachelor of Science in Medical Laboratory Technology Bachelor of Science in Surgical Technology Bachelor of Science in Medical Imaging Technology Bachelor in Optometry Bachelor of Science in Physician Assistant Bachelor of Science in Community Health Practitioner Bachelor of Science in Food and Nutrition Bachelor of Arts in Nutrition & Health Master of Science in Medical Laboratory Technology Master of Science in Medical Laboratory Technology (Microbiology/Clinical Biochemistry) Master of Science in Surgical Technology Master of Science in Medical Imaging Technology Master of Optometry Master of Science in Nutrition and Dietetics Master of Arts in Nutrition & Health Computer Sciences Master in Nutrition & Health DiplomaofinArts Computer Applications Bachelor in Computer Applications Bachelor of Science in Hardware and Networking Post Graduate Diploma in Computer Applications Master of Computer Applications Environment & Traditional Ecosystems Master of Arts in Environment and Social Development Social Sciences Bachelor of Science in Psychology Master of Science in Counselling Psychology Bachelor of Social Work Master of Social Work Master of Philosophy in Community Mental Health Arts and Humanities Bachelor of Arts in Music Master of Arts in Music Post Graduate Diploma in Peace Studies Management & Commerce Bachelor in Business Administration Bachelor in Tourism Administration Diploma in Rural Marketing Master of Business Administration (Human Resource/ Marketing/ Finance) Master of Tourism Administration Master of Commerce in Intl. Business & Accounting Master of Arts in Mission and Development Practice
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