APPLICATION FORM ISSUED TO : ____________________________________________

APPLICATION No :
  REGISTRATION No :
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APPLICATION FORM FOR ADMISSION TO
M.A.(English), M.Com., M.Sc.(Mathematics)
(Incomplete Application will be REJECTED)
(2020 - 2021)
PG Courses
1. NAME
2. DATE OF BIRTH
/
/
3. COMMUNITY: SC/ST [ ] MBC/DNC [ ] BC [ ] OC [ ]
4. PLACE OF BIRTH : __________________ 5. SEX : MALE / FEMALE / TRANSGENDER
6. CASTE : ___________________________ 7. NATIONALITY : ______________________
8. MOTHER TONGUE : __________________ 9. RELIGION : _________________________
10. AADHAAR No. OF THE CANDIDATE :
10a. NAD ID : ________________________ 10b. PAN No. : ________________________
11. NAME OF PARENT / GUARDIAN (STATE RELATIONSHIP) : _________________________________
12. OCCUPATION : ____________________ 13. INCOME (per annum) : Rs. ____________
14. ADDRESS FOR COMMUNICATION :


PIN

Cell : +91
e-mail id : _________
15. PERMANENT ADDRESS :


PIN

Cell : +91
e-mail id : _________

16. College previously studied with date of admission & withdrawal : __________________________________

17. Reasons for break of study, if any : ___________________________________________________________

18.Has the candidate reprented the University in atheletics or games? (If so,produce a certificate duly signed by the Director of Physical Education of the University with the full details):

19.Any information deserving special consideration of the applicant:

Details of Marks obtained in Degree Examination

Name of the Candidate : ________________________ College last studied : ________________________

Name of the University : ________________________

Name of the qualifying degree Major Ancillaries
1.
2.

Register Number : ____________________ Month and Year of passing : ____________________

State whether Semester or Non Semester : ____________________

Subject Marks obtained Maximum Marks Class obtained Percentage of Marks
Part I
Language / Alternative subject
Part II - English
Degree
Part III
    Major
    Ancillary I
    Ancillary II
Total marks in Major & Ancillaries *

* Note : Xerox copies of Mark sheets should be attached. Candidates can also apply on the basis of First Five Semester Marks.

Signature of the Applicant
Signature of the Certifying Officer
PLACE :
DATE :
Designation
Declaration : I DECLARE THAT ALL THE PARTICULARS FURNISHED ABOVE ARE TRUE AND CORRECT. I SUBMIT THAT I WILL ABIDE BY THE RULES AND REGULATIONS OF THE COLLEGE.
PLACE:
DATE:
SIGNATURE OF PARENT / GUARDIAN
SIGNATURE OF THE APPLICANT
FOR OFFICE USE ONLY

CERTIFICATES VERIFIED : ADMITTED To ........

UG MARKS COMMUNITY TRANSFER
CONDUCT SPL. CATEGORY

SIGNATURE OF STAFF WHO PROCESSED THE APPLICATION : ...........................................

SIGNATURE OF HEAD OF THE DEPARTMENT : ................................................................

Challan No. : .......................
Amount Rs. : .......................
Date : ....................... PRINCIPAL