/ SCHOOL OF SOCIAL WORK
AUTONOMOUS COLLEGE
(Affiliated to Mangalore University)
COLLEGE WITH POTENTIAL FOR EXCELLENCE
RE- ACCREDITED BY NAAC WITH ‘A’ GRADE-CGPA3.42
P. B. No. 521, ROSHNI NILAYA, Mangalore-575002

MASTER'S DEGREE COURSE IN SOCIAL WORK / Ph : 0824-2435791
APPL. NO ……………...
Dt. Recd………………....
Specialization Opted …….
Percentage of aggregate marks obtained(Optionals) …………..
AFFIX PASSPORT SIZE
PHOTOGRAPH / APPLICATION FORM FOR ADMISSION
A candidate for admission is requested to fill in all the details very carefully and clearly (if possible typed), refer to the Prospectus for admission rules which should be carefully studied. Affix a smallPassport size Photograph and remit a Registration fee of Rs.200/- which will not be refunded. Candidates who apply by post are requested to enclose a Demand Draft of Rs. 400/ drawn in favour of Principal, School of Social Work, Mangalore as application/registration fee. / Last date for submitting application
……………………………….
Students awaiting the results of the final year degree examination can also apply and submit the copy of the marks card of the examination at the time of interview.
  1. Full Name Ms./Mr ………………………………………………………..………………………………… (as in the Degree marks card)
  2. Date of Birth………………………………………... Place of Birth…………………………………….
    Age…………………………………………………. State of Domicile………………………………… Religion………….………….……………...... Scheduled Caste / Tribe ………….………….…..
    Caste and Subcaste………………………………….. Category ……………………….…………...... (Attach Proof) Mother Tongue ………………………………..….
  3. Home address: …………….………………………………………………………….…………………..…
    ………………..………….…………….……………e-mail…………………………………………
    Correspondence address………….………….………….…………. ……………………………..……
  4. Parent's Name: Mother…………………….………….… Father.…………….………….….……….…….
  5. (If Parents are not alive)Guardian's full name………….………….…………………….………….……….
    Address ………..………….………….………….……………… …………………………………….. … Occupation………………..…….……………e-mail…………………………………………………
  6. Marital Status: Single/Married …………………………………………………………………….……
    If married, Husband's/Wife’s name ………..………….………..………..…………………………….
    Address………..………….………..………..………….………..………..………….………..………..
    Occupation………..………….………..………..………….………..………..………….……..………..
  7. Whether Hostel Accommodation required (for Ladies only): Yes/No ….………….………….…………...
  8. Please give correct details of all University Education and Examination (Beginning from S.S.L.C)
    Give the number of attempts.

Name of
School
(S.S.L.C)
& College / Examination passed
(Year) / No.of
attempts / Class and
percentage of
marks / Degree
obtained / Subjects
studied
  1. Mention your talents, interests, hobbies, leisure time activities…………………………………………………
……………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………
  1. Give information about your family :
Name of Parents
Brothers & Sisters / Relation
to self / Age / Occupation / Annual Income
Note: Please attach attested copies(not original) of all the detailed mark-sheets of each year beginning
from S.S.L.C. and Conduct certificate(Originals to be produced at the time of the interview)
  1. If you are /were employed, give details of your employment:(Attach separate sheet)
  2. What languages do you know?
    LanguagesReadWriteSpeakUnderstand
  1. Do you have any disability / Physical or Psycological Health Problems? Yes / No
If yes, furnish Medical Certificate
14. Are you prepared to take up field practicum / projects / programmes allotted to you by the college
- Yes / No
15.Which specialization are you applying for?
Please put a tick mark against the selected specialization:
  1. Community Development(CD)( )
  2. Personnel Management and
    Industrial Relations(PMIR) ( )
  3. Medical & Psychiatric Social Work(MPSW) ( )
  4. Correctional Administration( )

I certify that, the information given in this application is complete and correct. I agree to comply
with all the rules and regulations of the Institute.
Date: Signature of Applicant
------
Note: Admission results will be declared after:
I / The candidate has appeared for an interview and a test.
II / Selected candidates will have to bring:
  1. Original Marks cards of Degree course(I, II & III year)
  2. Transfer Certificate from the Principal of the College last attended.
  3. Conduct Certificate from the Principal of the College last attended.
  4. Migration Certificate, Degree / Provisional Degree Certificate
    (for students from out side MangaloreUniversity).
  5. Eligibility certificate from the MangaloreUniversity (for students from Universities outside
    KarnatakaState)
  6. A Medical Certificate from a Registered practitioner.

III /
  1. Incomplete applications will be rejected.
  2. Canvassing in any form will disqualify the candidate for admission.
  3. Sponsored / Deputed candidates are required to obtain the prior approval of Mangalore University

IV / All admissions made to the college are provisional, subject to the final approval of MangaloreUniversity .University.
V / Candidates seeking admission to the programme should note that their original marks cards and other certificates produced at the time of admission to the programme will not be returned until they complete the programme.
PLEASE RETURN TO: Signature of Applicant
The Principal
School of Social Work
Roshni Nilaya, Mangalore – 575 002.