This form is free to download. Pay NRs 125/- while submitting this form in the college.

Application No.:
st. xavier’s college
MAITIGHAR, KATHMANDU, NEPAL Recent
DEDICATED TO EXCELLENCE, LEADERSHIP, SERVICE PP Size
( A COLLEGE RUN BY THE NEPAL JESUIT SOCIETY )
Photo
APPLICATION FORM
Group: PHYSICS BIOLOGY
(Not older than 6 months.)

Group once chosen cannot be changed. A candidate is allowed to apply only for one group.
PERSONAL DETAILS
Name of the Applicant:
(Use block letters) (First Name) (Surname)

Gender: Male Female Others Religion: ........................................ Nationality: .................................... Blood Group: .................
Date of Birth: (According to Birth Certificate) B.S. C.E.
mm/dd/yyyy mm/dd/yyyy

Ethnicity: (Tick an appropriate option) Brahmin/Chhetri Indigenous Madhesi Dalit Others ..................................
FAMILY DETAILS
Father’s Name: ........................................................................................................................................ Living : Yes No
(First Name) (Surname)
Father’s Profession: .................................. Department: ........................................ Mobile No.:
Mother’s Name: ........................................................................................................................................ Living : Yes No
(First Name) (Surname)
Mother’s Profession: ................................... Department: ........................................ Mobile No.:
Local Guardian (if any): Mr./Ms. .........................................................................................................
(First Name) (Surname)
Local Guardian’s Profession: ................................. Department: ........................... Mobile No:
ADDRESS DETAILS
Permanent: Temporary: (if different)
Block No: ........................ Ward No: .......................... Block No: ........................ Ward No: ..........................
Municipality/Gaunpalika:............................................... Municipality/Gaunpalika:...............................................
District: ................................. Province: ....................... District: ................................. Province: ......................
Mail ID: .......................................................................

Application No.: st. xavier’s college

MAITIGHAR, KATHMANDU, NEPAL
DEDICATED TO EXCELLENCE, LEADERSHIP, SERVICE Recent
( A COLLEGE RUN BY THE NEPAL JESUIT SOCIETY )
PP Size
ADMIT CARD Photo
Group: PHYSICS BIOLOGY (A copy of the photo pasted above.)

Name of the Applicant: (Use Block Letters)

(First Name) (Surname) Principal’s Signature

Applicant must bring this ADMIT CARD
* for the Entrance Examination.
* for the Interview if selected.
Applicant’s Signature: ........................... Guardian’s Signature: ........................... * for Admission if selected.
 ACADEMIC DETAILS
Name of the School Last Attended:
Address of the School Last Attended:
Name of the University/Education Board:
Last Year Attended: Name of the Degree/Certificate:

Academic Course Attended (SEE) Year passed Aggregate Marks % (if no CGPA)

SEE Marks/Grades: CGPA: English: Maths: Science: Opt. Maths:

FIELDS INTERESTED/PARTICIPATED
Please list the extra curricular activities you have participated in school/college.
Social Service:
Leadership:
Clubs:

Computers:
Other Activities:

Awards:
With whom will you stay while attending St. Xavier’s College? Parent Relatives Guardian Friends Hostel Rented Room
If you will be living with a relative or guardian, please state your relationship with them:
I certify that the information provided in this application form is precise, complete and true to my knowledge. I understand that any erroneous
or ambiguous information provided here may lead to disciplinary action, if found on a later date. The admission committee may confirm the
authenticity of my information and the documents submitted herewith. I agree to abide by the rules and regulations of the college and accept
the decision of the admission committee.

Student’s Signature: Parent’s/Guardian’s Signature:

Return the completely filled application forms with an Internet Print of SEE Grade Sheet.