Admission

Surname:

First Name:

Middle Name:

* (Enter your name as per 10th/12th/degree mark list).

Mother's Name:

Father's Name:

Date of birth:

Place of birth:

Sex:
Male Female

Domicile:

Merit Number Of Govt. List:

Merit List Qualifying marks:

Category:

Religion:

Caste:

Parent/Guardian Name:

Occupation:

Parent/Guardian Address:

Phone:

Local Guardian Name(if any):

Local Guardian Phone:

Local Guardian Address:

Wheather Hostel Accommodation is required ? Yes No

Past Academic details:

Exam	Board/University	Year Passed	Percentage	Name of the college last attended
10th
12th
First Degree (B.A.,B.Com.,B.E.,B.B.A.,)
PG Degree(PL mention)

Other Activities:
(Scholarship/Prizes won & Extra Curricular Activities)

Work experience:
Have a work experience? Yes No

Organization	Designation	Period	Duration

Computer knowledge(Pl mention):

Upload photo:

Upload signature:

Declaration:

I declare that, the information given by me in this application is true.

I have not been deberred from appearing at any Examination held by any stetutory examination authority in india.

I am aware of the rules,acts and laws towards my studentship at this institute and hereby confirm to abide by the same.

I undertake that so long as I am a student of this Institute.I shall not do anything inside or outside the Institute which may result in-disciplinary action against me.

I fully understand that the Director of this Institute shall have right to expel me from the Institute for any infringement of the rules of conduct and discipline.

PLACE:

DATE: 04/06/2023

Signature

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