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57 views

PFORM2

HTML Project Pgdca

Uploaded by

raamsharma0129
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Mahant Kishore Puri Mahila College of Technology

Ghata Mehandipur Balaji District Dausa (Raj.) 321610


Run by Shri Balaji Mahila Vidyapeeth Shikshan Sansthan

Admission Application Form


(Session 20 - 20 )

Serial No…………… Admission Date……/……/………..

1. Full Name of Student (In HINDI) …………………………………………………………………………………..........................................

(In ENGLISH) ………………………………………………………………………………….........................................

Student Email: …………………………………………………………………………………......................................

2. Date of Birth…………..............................In Words…………………………………………………………….......................................

3. Caste………………………………………………….SC /ST/ SBC /OBC/GEN………………………………………………...............................

4. Father's/Husband's Name…………………………………. Contact Number……………………………….......................................

5. Mother's Name…………………………………………………. Contact Number……………...........................................................

6. Patron Name and Relation with Student………………………………………………………………………........................................

Contact Number…................................: ....................................................... ......................................

7. Patron Address………………………………………………………………………………………………………………......................................

8. Permanent Address……………………………………………………………………………………………………….......................................

9. Aadhar Number………………………………………………………………Bhamasha Number…………………....................................

10. Details of examination passed last years


Exam Roll no. Year Subject Board/Uni. Total Marks Obt. Marks pct.
th
10

12th

BA/BSC/BCA
/B.COM
MA/MSC/M.
COM

B.ED/OTHER

11. Name of last College Studied……………………………………………………………….


12. Hostel Facility Yes. No.…………………………………….............................
Declaration
I hereby truly declare

1. That during last period of study i have not done any indiscipline or public misdeed.
2. That I will follow all the rules of the college In case done any such indiscipline and violation of rules my
admission can be cancelled.
3. That if I am absent from the college for 5 days without prior notice my admission can be cancelled.
4. That if I have less than 75% attendance my admission can be cancelled.
5. That I will not carry mobile phone to the college If found guilty phone will be confiscated and entry will be
cancelled.
6. That hostel I will follow the hostel rules.

Date Student signature

I……………………………………………………………………………………………Father/husband/patron…………………………………………

I assure that in case of any kind of indiscipline and violation of rules by The student I will not have any objection

if her admission is cancelled.

Date Sign. of father/Husband/patron

the candidate is eligible admission is Temporary Admission


for admission allowed/not allowed is Granted

Sign. In charge/lecturer Signature of investigator Signature of Principal


(Committee member)
Date…………………… Date……..................

Note: Enclose the following original certificates and their photocopies.

1. Copy of 10th Marksheet

2. COPY of 12th Marksheet

3. Original marksheet and copy of graduation.

4. Transfer certificate/original copy of Tc

5. Character certificate.

6. Photocopy of aadhar card

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