Registration Form Reg No.

Course Opt for: Subject Combination: Optional/Compulsory Personal Information Name: DOB: E Mail Id. Fathers Name Department Contact No (O) Mothers Name Contact No(O) Address Permanent: . Current/ Mailing Address: Name of the Examination Class 10 Class10 + 2 Bachelor Degree Others Facility Required: Medium Opted: Hindi Board/ University Academic Record Name of the school/ Institution Passing Year Percentage of marks (exact) Contact No Marital Status: Married Category: SC ST OBC Single: GEN PH Date:

Occupation Post Mobile/Res Occupation Mobile/Res

Transportation Yes Hostel Yes English

No No

(Please tick the required one) If you have failed or dropped at any stage, give details with reason: Name of the Board/ Name of the Institution Year Examination University

Reason/ Result

Last achievements if any: Cultural:

Academics:

Sports:

Others:

Please enclose Xerox copy of the certificate/ diploma. Scholarship received if any:

Mode of fees payment opted: Lump sum Installments Amount

Amount

Admission Time 30th Sep 30th Dec I have received the fees structure and fees payment schedule and I agree to pay the fees as per the schedule. Remark (if any)

Signature of the candidate Admission Rules Date: Place:

Signature of the guardian

Candidates will not be admitted to a course without completing admission procedure and forms. Every candidate will have to come regularly in time & finish the assignments in given time frames. Every candidate should abide by the rules and regulations of the institute and have to complete the attendance as per the university/ PGI regulations. All the equipments & computers of the institute have to be handled carefully and as per the given instructions. If there is any loss due to carelessness, the concerned candidate will have to pay penalty for the damages. Fees once paid shall not be refunded under any circumstances. Final examination shall be conducted as per the guidelines of the affiliated body while incase of PGI. Late fees/ installment charges are applicable as per rule. Rules for Provisional Admission Registration fee for Provisional Admission is Rs. 10,000. Only 50% of fee is refundable only in the exceptional case of not qualifying the examination needed as the eligibility for the opted course. In any other case the fees is not refundable. If the college is not informed about the result of the student within 7 days of its declaration the provisional admission will be cancelled and the seat shall be allotted to the other student. Original documents should be submitted in the college within 7 days of result declaration. Declaration by the student I acknowledge having read and understood the conditions set forth in the academic catalogue, admission rules as well as the payment terms and conditions and I declare that I accept the terms and conditions set forth herein. I commit to follow the uniform norms (dress code) of the college. I will do nothing either inside or outside the college premises that will interfere with its orderly working and discipline. I declare that I have not been involved in unfair means at school / university examinations. I hereby declare that the information given in this form is correct and I will be held responsible if found incorrect.

Signature of the candidate

Signature of the guardian

Course Opted for: Last Class attended Universities enroll. No Subject Combination Fees Option Opt: Lump Sum Fees payable Mode payment Cash Cheque

For Office Use Only: Batch/ SessionCategory: Percentage of marks secured (if applicable) Installment Payment Date Amount Remark if any

Documents Enclosed: Mark sheet of qualifying examination (Original) 10 +2 Graduation Xerox of secondary examination certificate Original TC from the Institute last attended Original Migration Certificate for students who passed 10+2 with board other than RBSE Xerox Copy of ST/ SC/OBC/ PH Certificate Original Income Certificate (In Case of ST/ SC/OBC/ PH candidates) by Tehsildar. Xerox copy of Caste certificate (In Case of ST/ SC/OBC/ PH candidates) Affidavit in case of non submission of original mark sheet/ documents required for confirmation of admission/ enrollment in University Remarks (if any) .. Authorized signature Admission In charge Format to be filled for identity card (Please fill in Capital Letters) Name: Date of Birth: Course: Address: Contact no.: Valid up to: Year: Fathers name:

Reg. No.. Name of the student .. Fathers name. Contact No Course Batch/ Session. Fees to deposit Remarks if any . Authorized signature with seal Admission In charge (Please deposit the fee only at fee counter and collect the proper receipt for the amount paid)