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    Vivek Gutam
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    36 views5 pages

    Admission Form

    Uploaded by

    Vivek Gutam

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
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    perce rye "PEOPLE'S UNIVER’ 5 IT 1 AC isosoorz015 cornea) PEOPLE'S COLLEGE OF PARAMEDICAL SCIENCES & RESEARCH CENTRE People’s University Campus, Bhanpur, Bhopal -462037 Madhya Pradesh, India PLICATI IM SESSION 2015 (CONTACT NO, 07554005295 For Office Use Only Cae Form No, Nationality indian Foreign Batch commencing Application No. ‘Application received on ‘Application fee paid Passport size ‘Application Status Branch Code mn ] phat Course Code ] ‘STUDENT'S PROFILE (TO BE FILLED IN BY APPLICANT IN BLOCK LETTERS) Preference: - *AS per 10 Marksheet ‘Course opted by the student Surname First Name Middle Name Full Name in Hindi Gender Male Female Blood Group sc ] ST OBC] Gen Date of Birth d] of M[ |v [¥[¥| ¥| Category ‘Age as per certificate at 30° November 20..... YL¥ M[M Religion ‘Address of correspondence Email: Phone: Residential (Landline) Parent's /Guardian profile Father's Name in English Father's Name in Hindi >canned witn Camscann ‘Mother's Name in English mother’s Name in Hindi Guardian Name. ‘) in case guardian, relationship to guardian b)Address Pin Code Email Phone Whatsapp No. ‘Aadhar no. Migration no. Residential ID MARK Requirements during admission Class X Pass Certificate (Original +6 Attested Copy) Class Xil Pass Certificate (Original +6 Attested Copy) Character /Conduct Certificate (Original + 1 Attested copy ) ‘adhar Card (2 Attested Photocopy) Domicile Certificate ( 2 Attested Photocopy ) Migration Certificate ( For Other State /CBSE) (original+5 Attested copy ) Transfer Certificate (original+5 Attested copy ) Gap Certificate ( for those who had a gap after (12) (Original ) - if not available in 10" Mark sheet) ( Attested Photocopy ) Birth Certificate (D.0. Bill (Attested Photocopy ) Voter ID /Passport /Address Proof /Electri Caste Certificate (for reserved category ) (2 Attested Photocopy ) Passport Size Photograph ( 6 Nos )/ (Black & White only }+Photo JPEG below 200KB 8 Self Addressed Stamped Envelope ( Minimum Size 9”x4’) Income Certificate For SC/ST/ OBC/ Minority (Scholarship Students) 2 Attested Photocopy Scanned copies of all the above mentioned original documents ocann — ~ “ MARKS DETAILS OF CLASS-XIL Name of the Board Year &Month of passing | Subject ‘% Marks school Physics (P) Chemistry(C) Biology(8) English(e) PCB aggregate ‘Maths & /or other subject Ll ANY ADDITIONAL EDUCATION QUALIFICATIOF Diploma /Degree /PG | Subject Studied | Name Of University | Year of Month Total % of Passing Of Marks Declaration by candidate S/0/P/o, Declare that, to the best of my knowledge and belief, the above particulars are true, | agree to confirm to the rules and regulations at present in force or that may hereafter be made4 by the administration of the college. | undertake that | will not do anything unworthy as a student of this college or anything that will interfere with orderly functioning and

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