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    Academic year :

    Select the course you wish to apply for :



    Name of the Student:

    Student Mobile Number (Whatsapp):

    Date of Birth :

    Blood Group :

    Entrance Exam Taken:

    Nationality :

    Religion :

    Category :

    Caste :

    Sex :
    MF

    Mother Tongue :

    Parents Information

    Father / Guardian

    Mother

    Name

    Education Qualification

    Occupation

    Name of the Company

    Designation

    Office Name – Address & Phone No

    Email-ID

    Mobile Number

    Permanent Address

    Address :

    Phone No (with ISD / STD code) :

    Address for Correspondence

    Address :

    Phone No (with ISD / STD code) :

    Details of SSLC / X Std.

    Name & Address Of Institution :

    Board :

    Year Of Pass :

    State :

    Subjects

    Marks

    Total :

    Details of PUC / XII

    Name & Address Of Institution last studied :

    Reg No. :

    Board :

    Year Of Pass :

    State :

    Part I (Languages)

    Marks

    Part II (Core Subjects)

    Marks

    Total :

    Declaration By The Student

    1. I hereby agree to abide by the rules and regulations of the University, the State Government & the college regarding my admission, to be approved based on eligibility criteria and submission of testimonials in original as stipulated by the University.

    2. I agree to abide by all the rules and regulations regarding payment of fees for my course. Payment of fees on time is my/ parent’s responsibility and any delay will attract fine as decided by the Management from time to time. I accept that refund of fees is not allowed under any circumstances.

    3. I declare that I shall not indulge in ragging, eve-teasing, smoking, consuming alcohol drug abuse or any other anti-social activity in the college premises, on educational tours, industrial visits or elsewhere.

    4. I shall abide by the dress code prescribed by the Institution.

    5. I shall abide by the rules and regulations of the Institution in force, which may be amended from time to time by the University/ Management/ State Government/ and/ or any other regulatory authorities. The decision of the Management with respect to any administrative or academic matter shall be final and binding on me at all times.

    6. I shall accept the decision of the authorities in all matters of training, conduct and discipline with no right to question any of them.

    I declare that the particulars furnished above are true to the best of my knowledge and belief. I have read and understood the rules and regulations for my admission to course and shall abide by the rules and regulations that shall be binding on me at all times.

    Place

    Date :

    Declaration By Parent / Guardian

    I hereby declare that my ward does not suffer from any disease/ ailments. I know the financial obligations of my ward and I can afford to pay all the costs and undertake to pay the tuition fees and other fees payable on time to the college as per the rules in force and which may be amended from time to time by the Management. I am aware of the fact that the fee paid to the college for admission will not be refunded in case he/she does not join the course, he/she discontinues the studies, he/she is expelled from the college for any reason. I also stand by the declaration given to the college by my son/ daughter.

    I declare that the particulars furnished above are true to the best of my knowledge and belief. I have read and understood the rules and regulations for my ward’s admission to course and shall abide by the rules and regulations that shall be binding on me / my ward at all times.

    Place

    Date :