University/College ____________________________.

Application for: B.A (Hon) / B.Sc (Hon) / F.A / F.Sc

(Tick any one)

Group: (i.e. Pre-Eng, Pre-Med. etc)_______________________Session______________

Staple
attested
Photograph
(04 Nos)

Name (In Block letter) : ____________________________________________________

Father Name_____________________________________________________________
D.O.B ________________________ Age on 01-08-2015 __________________________
Domicile ____________________________Distt:________________________________
Permanent Address:_______________________________________________________
_______________________________________________________
_______________________________________________________
Landline No.________________________

Cell No.____________________________

E-mail: __________________________________
Mailing Address:

_______________________________________________________
_______________________________________________________
_______________________________________________________

Track Record:- (Start from last Exam passed)

Name of Exam

Roll No

A/S

Year

Obtained

Total

% age

Intermediate
Matric

Dated: __________________

____________________
Signature of Candidate

APPLICATION FORM FOR B.A (HON) / B.SC (HON) / F.A / F.SC

(Tick any one)

Group: (i.e. Pre-Eng, Pre-Med. etc)___________________________Session__________

Staple
attested
Photograph
(03 Nos)

Name of Institution:- ______________________________________________________

Name (In Block letter) : ____________________________________________________
Father Name_____________________________________________________________
D.O.B ________________________ Age on 01-08-2014 __________________________
Domicile ____________________________Distt:________________________________
Permanent Address:_______________________________________________________
_______________________________________________________
____________________________Contact No._________________

Mailing Address:

_______________________________________________________
_______________________________________________________
____________________________Contact No._________________

Track Record: - (Start from last Exam passed)

Name of Exam

Roll No

A/S

Year

Obtained

Total

% age

Intermediate
Matric

Dated: __________________

____________________
Signature of Candidate