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Application Form For Admission
Stream :
Course Name :
Name of The Application :
Date of Birth :  
Sex :
Male Female
Nationality :
Caste :
Category   :
Name of Parent / Guardian :
Address For Correspondence :
State :
Pin Code :
Telephone Number :
Mobile No. (Applicant) :
Mobile No. (Parents/Guardian) :
Email Address (Applicant) :
Email Address (Parents/Guardian) :
Photograph :
     
Details    
Year Board Total Marks Marks Obtained Percentage
Detail of 10+2 Subject Wise Marks of 10+2
Year
S.No Subjects Maximum
Marks
Marks\
Obtained
% of
Marks
1.
2.
3.
4.
5.
6.
7.
Total
School
Board
Detail of UG / Diploma Course>    
Qualifying
Exam
College University
 
Year/
Semester
Marks\
Maximum
Marks\
Obtained
% of
Marks
Month
& Year
1SEM
I Year/
II SEM
III SEM
II Year /
IV SEM
V SEM
III SEM/
VI SEM
VII SEM
IV Year/
VIII SEM
Total
Particulars of the Tuition Fee & Exam Fee Paid
(ON THE REVERSE SIDE OF THE DRAFT ,WRITE DETAILS AS MENTIONED ABOVE OF THE GUIDELINES IN THE PROSPECTUS)
DDs Amount DD No.  DD Date Bank
DD-1
DD-2
DD-3
Total Amount
Total DD
 
Declaration By Applicant (In Case of ProvisionalAdmission)

S/D/OSeeking admission to   Course on provisional basis subject to confirmation by University. I hereby agree that in case I am not able to fulfill the eligibility criteria before stipulated time as per norms, my candidature for the said course would stand cancelled and I shall not be entitled to refund of any fee paid by me. The university reserves the right to declare result of my semester examination until I submit my certificate of clearance of eligibility in this regard. In the event of any information being found incorrect of misleading, my candidature shall be liable to be cancelled by the university at any time and I shall not be entitled to refund of any fee paid by me. I hereby confirm that I have read and agree to detail terms and conditions mentioned on prospectus.

Date :  
Place :
     
 
 
 
   
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