Admission Form 2017-18


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Applicant Name *
 

Father's Name *
 

Mother's Name *
 

Telephone No. *
 

Date of Birth *
 

Place of Birth & District *
 
Seeking Admission In


Address for Communication*
 

Occupation of Parent/Guardian
 

Annual Income
 

Wish to join Hostel   

Adhar Number
 
Upload Photo *

Religion (if Catholic enclose Baptismal Certificate)
 

Community


Mother Tongue
 

Email Id
   

Intermediate Details

College Name

Class Obtained

March/September
 

 

 
Marks Obtained

Year

Registration No.

 

 

 


Jr. Inter


Sr. Inter
Year-Month

 

 
Part I
(English)

 

 
Part II
(Tel/Hin)

 

 
Part III
Physics
Th
 

 
Pr
 

 
MAT/BOT
Th


Pr


CHE
Th
 

 
Pr
 

 
ZOO
Th


Pr


Grand Total     


First Language :  

Second Language :  
Medium :  

Combination wanted under Part III :
















All Degree Students must enroll themselves in one of the three major Co-curricular programmes

Give your preference below :
1.

2. Extra Curricular Activities in School :

i) FINE ARTS & LITERARY ACTIVITIES








ii) SPORTS & GAMES










Give the names of relatives, if any, of past and present students and Employees of this College.
Name
Year
Present Position
Relationship
Present Address with Phone Number
Upload Applicant Signature
Upload Parent/Guardian Signature