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Admissions Form (#3)

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First Name

Last Name

Expansion of initial (if any)

Age & date of birth (as in SSLC book)

Gender

Male

Female

Others

Nationality:

Religion & Cast

Mother Tongue:

Second language (for B. Com. students only)

If eligible for reservation

Permanent Address:

Address Line 1

Address Line 2

City

State

Zip Code

Country

Address to which communication is to be sent

Address Line 1

Address Line 2

City

State

Zip Code

Country

Mob (Parent):

Mob (Student)

Name of Parent / Guardian

Occupation of Parent / Guardian

Annual Income

Residents during college days

With parents

With Relatives

College Hostel

Name & Address of local guardian if any

Name of Guardian

Address Line

City

State

Zip Code

Country

Name of the institution last studied with Period of study (Qualifying Examination)

Examination passed with register number (s) Month & year (attach attested copy of mark list)

Date

Attainment on Sports, Games, NCC, NSS etc. (Attested copies of certificates to be enclosed)

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Claims if any on account of being Physically Handicapped or children of Ex-Servicemen (Relevant certificate to be attached)

If yes, Application No.:

Course

Whether studied for any other course after the Qualifying Examination (If so Give Details)

ACADEMIC QUALIFICATION

Matriculation

School Attended

YEAR OF PASSING

PERCENTAGE OF MARKS

Details of Marks Awarded in the Qualifying Examination

Paper I :English

Paper II : Second Language

Paper III

Grade

Marks Obtained

Maximum marks

Total Marks Obtained

Total Maximum Marks

DECLARATION

I do hereby declare that the particulars given above are correct and that I will abide by the rules of the college.