Mehr Chand Mahajan DAV College For Women

Sector 36-A, Chandigarh

College Admission Form (SESSION 2019-20)
Online Form No.: 13577
TO BE ALLOTED BY OFFICE
Roll No........................................
Application for admission to: BAI
Pool : NA
Reserved Category : OTHERS
Category : GENERAL
Previous Examination passed in year : 2019
Gap year : NA
Marks in previous examination: 410.00/500.00 Percentage: 82.00
Old College Roll No. : Session: 2019
Conveyance (Scooter/Motorcycle) : No Vehicle No.:
PU Roll No. : NA PU Reg. / PUPIN No.: NA
Boarder/Day Scholar :

Student's Details
Candidate Name: ASHMEET KAUR Date of birth: 19-10-2000
Gender: Female Blood Group: B+
Minority Status: No Religion: NA
Nationality: INDIAN Aadhar No.: 799281209149
Contact 7300990747 EPIC No:
Email: [email protected] State: Uttar Pradesh
Permanent Address: 11 AVAS VIKAS CIVIL LINES Correspondence 11 AVAS VIKAS CIVIL LINES
BAREILLY UTTAR PRADESH Address: BAREILLY UTTAR PRADESH

Belongs to BPL: No Annual Income: 2 to 5 lac

Special Achievements
Cultural : No Sports : No
Academic : No
Achievement Remarks :

Father's Details
Father's Name: SURJEET SINGH Occupation: CHEMIST
Email: [email protected] Office Address: 136 B CIVIL LINES CURCIT HOUSE
CROSSING BAREILLY
Contact no: 9319605151

Mother's Details
Mother's Name: ATAMJEET KAUR Occupation: HOME MAKER
Email: [email protected] Office Address: 11 AVAS VIKAS CIVIL LINES
BAREILLY UTTAR PRADESH
Contact no: 9359755252

Guardian's Details
Guardian's Name: PARAMJEET KAUR Occupation:
Email: Office Address:
Contact no:
Sports Category
Sports Seat : No
Sport Name : NA
Page 1.
(Admission against sports seat will be as per Panjab University Rules)
Course Information
Course Name: BAI
Medium: English
Selected Subjects: Compulsory (as per syllabus)
ENGLISH COMPULSORY
ENVIRONMENT AND ROAD SAFETY EDUCATION,VIOLENCE AGAINST
WOMEN/CHILDREN AND DRUG ABUSE.
PUNJABI COMPULSORY
Electives
SOCIOLOGY
HOME SCIENCE
PSYCHOLOGY
Honours
No Honours Subjects
Add-On course
COMMUNICATIVE ENGLISH
Academic Record
Month & Marks/
Examination Board/ School/ Division Percentage Subjects Reappear
Roll No. Year of Max
Passed University College Studied Subject(s)
Passing marks.
PSYCHOL
YPS OGY, SOCI
10 + 2 Or 410.00 /
ICSE PATIALA, 6475680 2019 FRIST 82.00 OLOGY, PASS
Equivalent 500.00
Punjab ENGLISH,

YPS ENGLISH,
PATIALA 432.00 / PUNJABI,
Class X ICSE 6475680 2017 FRIST 72.00 HISTORY, PASS
PUNJAB, 600.00
Punjab GEOGRAP

FOR POSTGRADUATE STUDENTS ONLY*

(Details of the Subject in which applying for masters)

Subject Marks Max. marks Percentage

Bechelor's Degree
Class ..........

Honours

Elective
(Aggregate of 6 Semesters
in Subject applied for)
Old Student Seeking Admission in Semester III

PG Semester I

PG Semester II

For Admission to MSC I Chemistry

O-CET RollNo. ____________________Score__________ 50% of the marks in O-CET ____________________50% of the marks in BSc _____

FOR FOREIGN STUDENTS ONLY

Citizen of NA Passport No. NA Valid Upto NA
Student Visa No. NA Valid Upto NA Residential Permit No NA
Permit validity NA ICSSR Sponser NA Equivalence Certificate NA

(Name & Signature of Dean Foreign Students)

Page 2.
 FOR MIGRATION CASES ONLY
Migration certificate NA
Former Board / University. Deficient Subject(s)
In case of deficient subjects you have to clear the subjects within the permissible chances.

(Signature of Student) (Signature of Parent/Guardian) (Name & Signature of Dean Migration)

ALUMNI
(Ex-Student of Mehr Chand Mahajan DAV College for Women.)
Is any one of your relative an ex-student of this Collage? No
Name NA Passing Year NA
Occupation NA Designation NA
Contact No. NA E-mail NA
Any Other Information NA

Certified that the admission form has been checked and the student is eligible for admission to BAI class provisionally.

Date:..................... Signature of the Scrutineer:...............................

Name of the Scrutineer:................................
(Recommended for Provisional Admission)....................................

Name & Signature of Convener Admission Committee (Signature of Principal/Dean Admissions)

..........................................................
DOCUMENTS TO BE ATTACHED
1. Original Documents are to be shown at the time of Admission.
2. Attach one extra photograph with form.
3. New Student should attach self attested photocopies of the following documents:
i) Detailed Marks Certificate of all the results c). Reserved Category (if any).
mentioned in the academic record column. vii)Relevant Certificates required (if applicable):
ii) Date of Birth Certificate.(Class X Certificate). a) Migration Certificate (for students of the other
iii)Character Certificate by College/School last Boards / Universities). Check Collage prospectus for
attended.
iv)Proof for seeking exemption in Punjabi more details.
Compulsory.(X Marksheet) b) Cancer, AIDS and Thalassaemia candidates must
(only for Undergraduate Students) attach a certificate of proof from the national
v)Anti-Ragging Declaration, at the end of the form, medical institutes like PGI, AIIMS etc.
must be signed by students and Parents/Guardians c) Achievement in sports if seeking admission
vi)Affidavit: against sports seat.
a) Gap year (if Any) d) Eligibility Certificate (for foreign students only).
b) Girl Child Affidavit (on a stamp paper worth Rs. viii)Students seeking admission in Postgraduate
20/-) duly attested by a first class magistrate. Parents Course Semester I must attach :
must declare that the benefit is being obtained for a) Self-attested photocopies of the detailed mark
only one girl child in case of two girl children. sheets of all the six semesters of the graduate
degree.
b) Honours mark sheet must also be attached with
the admission form.

4 . Old student should attach a self-attested photocopy of the result of all the preceding semester examinations.
NOTE:
1 . The candidates should understand that the admission if granted would be provisional and subject to confirmation by Panjab University.
2 . Incomplete application form or form with wrong or deliberately concealed information is liable to be rejected.

Page 3.
 DECLARATION
1. I hereby declare that I have noted all the information and instructions given in the College Prospectus.
2. I pledge to abide by the rules and regulations of the Collage and the University and will not associate myself with any activity that goes
against the discipline of the institution.
3. I declare that the facts stated above are true and that I have not so far been admitted to any affiliated Collage in the class to which I am
seeking admission in this Collage.
4. I solemnly declare that I have not been disqualified by any University for the class I am joining in this Collage.
5. I will have no claim to admission if found ineligible by Panjab University.
6. All information provided by me is correct and any misrepresentation of facts / information found hereafter may lead to my
expulsion from the Collage.
7. It is my personal responsibility to inform the Collage office of any change in my address / phone number or that of my parents /
guardians. The Collage is not responsible for any gap in communication in case the personal information is not updated by me.

Dated...........

Signature Of Student
Email: [email protected]

UNDERTAKING

I ASHMEET KAUR seeking admission to BAI has gone through the prospectus of the Collage/Hostel and hereby submit I am aware
of the following rules and regulations of the Collage that:
1. Minimum of 75% attendance in all subjects is mandatory.
2. Mid-semester test is compulsory and minimum of 25% marks in aggregate of all subjects in MST is required.
3. No lectures will be granted for medical leave or any other leave. The leave will only ensure that the student's name will remain on
the Collage rolls and will not be struck-off.
4. The name of the student will be struck-off the Collage rolls in case of absence for continuous period of 7 days without leave from
the Collage authorities.
5. Non-fulfilment of any or all of the above mentioned conditions will lead to student being made private or detained in the final
examination.
6. All the academic rules and regulations of the Collage including attendance, examination, internal assessment or any other
requirement of the course has to be adhered to by the student.
7. The fees and all the dues have to be paid as per schedule notified by the Collage from time to time.
8. Identity card provided by the Collage must always be carried and produced by the student to any faculty member, security
personnel and staff on demand.
9. The notice board has to be read daily and Collage shall not be responsible for conveying any information to individual student.
10. All rules and regulations and code of conduct of the Collage as amended from time to time with respect to academics,
discipline, lab/workshop, library, transport, vehicle parking etc. have to be abided by the student failing which disciplinary action
can be taken by the Collage authorities.
11. The student is liable to be penalized for any kind of indiscipline, use of abusive language, misbehaviour, disobedience or any act
of physical violence. No outsider will be allowed in the premises to intervene on behalf of the defaulting student. The student found
guilty can even be rusticated from the Collage.
12. Tampering with staff vehicles will lead to strict disciplinary action against the student found guilty of doing the same.
13. The Collage bears no responsibility for any loss or damage to the student's vehicles or its parts/accessories.
14. The use of mobile phones in the restricted zone of the campus will incur serious disciplinary action which may even lead to
expulsion from the Collage.
15. The Collage bears no responsibility for any kind of compensation in case of any damage or loss of cash, valuables including
mobile phone, jewellery or personal belongings.

Signature Of Student
Email: [email protected]

Page 4.
 ANTI-RAGGING DECLARATION

I ASHMEET KAUR, D/o ( Father & Mother) SURJEET SINGH &ATAMJEET KAUR Roll No.____________ student of Class
BAI seeking admission to Mehr Chand Mahajan DAV College for Women, Chandigarh, do hereby undertake on this Day
___________ Month _______________ Year _________ the following:

1. That I have read and understood the directives of the Hon’ble Supreme Court of India on anti-ragging and
the measures proposed to be taken in the above reference.(Available at www.mcmdavcw-chd.edu)
2. That I understand the meaning of ragging and know that ragging in any form is a punishable offence and the same is banned by
the Court of Law.
3. That I have not been found guilty or charged for my involvement in any kind of incident of ragging in the past. However, I
undertake to face disciplinary action / legal proceedings including expulsion from the College, if the above statement is found to be
untrue or the facts are concealed at any stage in future.
4. That I shall not resort to ragging in any form at any place and shall abide by the rules / laws prescribed by the Courts,
Government of India and the College authorities for the purpose from time to time.

Signature Of Student
Email: [email protected]
I hereby fully endorse the declaration made by my child / ward.

Signature of Mother / Father or Guardian

It is compulsory for every student and parent to submit an Online Anti-ragging undertaking every academic year at:
www.antiragging.in / www.amanmovement.org

STATEMENT BY PARENTS /GUARDIAN

We hereby affirm that we have read the rules and regulations of the College/Hostel and promise to abide by them. We assure that
ASHMEET KAUR who is seeking admission to BAI has signed the undertaking in our presence and will conform to the above- stated
standards in conduct and academics.

Signature of Parent/Guardian
Date:__________________

For Office Use Only

Certified That the student Is Eligible for Admission to BAI ( Recommended for Provisional Admission )
Deficiency If Any:

(Signature of Teacher with Date) ( Signature of Convener with Date )

Name of Teacher Name Of Convener
Admission Committee

Page 5.
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