APPLICATION FORM

Session 2018 - 2019

Course Details
Course Applied for(B.Sc/B.Com/
BBA/BCA/M.Sc)
Year/Sem
Course Year Group
Personal Details
Name of the student
( as in high School Certificate)
Date of Birth(As in High
School Certificate)
Father's Name Occupation
Mother's Name Occupation
Guardian's Name Occupation
Father's/Guardian's Annual Income
Permanent Address
Nearest Police Station Email Address Parents Mobile No.
Local Address Candidates Mobile No.
Religion Category
Nationality   State (Domicile)
Blood Group Gender
Academic Qualification(starting from Xth or equivalent)
Examination Passed Year Name of Board/University Subjects Marks Obtained %age/CGPA
High School / Equivalent
Intermediate(10+2)/NIOS
B.Sc.
M.Sc. 1stYear
Enclosure: Check List(Tick whichever is applicable)
Highschool
Intermediate
TC
Migration
Aadhar
Student Signature/Parent Signature
Declaration by the Candidate
I hereby declare that all the inforamtion given above is true and complete to the best of my knowledge and belief , and nothing has been cocealed or distorted. further, I agree to abide by the rules and regulations. If at any time, I am found to have concealed or distorted any information and in case of misconduct, my admission shall stand cancelled and I shall be liable to such disciplinary action as may be decided by the college.