Check List

izo's k vkosnu QkWeZ ds lkFk tek djkus okys nLrkost

1- izos'k QkWeZ
2- 3 ikliksVZ lkbt QkWVksa
3- 'kiFk i=
4- tkfr izek.k i=
5- ewyfuokl izek.k i=
6- vk/kkj dkMZ
7- 10th Mark Sheet
8- 12th Mark Sheet
9- Graduation (1st,2nd, 3rd year)
10- Post Graduation
11- TC+CC
12- Migration Certificate if other than GGTU
 GOVIND GURU TRIBAL UNIVERSITY, BANSWARA

ADMISSION APPLICATION FORM

Year – 2022-23

Apply For (Course with Subject) ...................................................................................................

j
Challan No ........................
Tick The Category Applicable
Date ........................... Gen. OBC SC ST MBC P.H. K.M. EWS
Bank ................................. Recent
Passport
Size
Bachelor's Degree*
Photographs
B.A. B.Com. B.Sc. B.E. B.B.M. BCA Other
Appearing at Bachelor's Degree Final
Exams Yes

Name of Candidate (Leave one square blank after each word)

Permanent Address (Do not repeat the name)

PIN Mobile Number

E-mail
Aadhar Number

Date of Birth Nationality Sex

Male Female

Father's Name and Address

Occupation/Designation

PIN TELEPHONE

Mother's Name

Guardian's Name and Address (If parents not alive)

PIN TELEPHONE
Educational Qualification :

Total Marks
Examination Subjects Board/University Year % Division
Marks obtained

10th

12th

Graduation

Post Graduation

Others

Bachelor's of 10+2+3 Scheme will be considered only.

In case of grade, authentic conversion formula must be given.

I declare that the information given by me in this application is true and complete in all respects
to the best of my knowledge. I understand that the suppression of fact or false information may
lead to cancellation of this application. I also hereby agree to comply with the rules of the
university if admitted.
मैं घोषणा करता/करती हूँ कक इस आवेदन में मेरे द्वारा दी गई जानकारी मेरी जानकारी के अनुसार सभी प्रकार से
सत्य और पणण है । मैं समझता/समझती हूं कक तथ्य को छिपाने या गलत जानकारी दे ने से यह आवेदन रद्द ककया
जा सकता है । मैं ववश्वववद्यालय के छनयमों का पालन करने के छलए भी सहमत हूँ

Place __________ Date ________ Full Signature of Applicant

 uohu izos'k vkosnu ,y-,y-ch- l= 20--------&---------
'kiFk i=
eS ---------------------------------------------------------------------iq=@iq=h@ifRu -------------------------------------------------------------------tkfr ---------------

---------------------- mez------------------------- fuoklh----------------------------------------------rglhy---------------------------------- ftyk------------------------

------------------------- jkT;------------------------------------esa fof/k foHkkx xksfoUn xq: tutkrh; fo'ofo|ky;] ckalokM+k esa

,y ,y ch@,y,y,e@fMIyksek--------------------------------------- ikB~;dze------------------------------------------------------------------- esa

izos'k gsrw 'kiFk iwoZd c;ku djrk@ djrh gqW &

1- ;g fd] uohu izos”k@uohuhdj.k vkosnu&i= esa esjs }kjk nh xbZ leLr lwpuk,W ,oa layXu vadrkfydk@izek.k
i= nLrkost lgh gSA
2- ;g fd] esjs Lukrd@LukrdksŸkj ijh{kk lkekU; oxZ esa 45 izfr”kr ,oa vU; fiNM+k oxZ 42 izfr”kr ,oa vuqlwfpr
tkfr@vuqlwfpr tutkfr vH;FkhZ ds #i 40 izfr”kr ls ,d Hkh vad de ugh gSA
3- ;g fd] esa xksfoUn xq: tutkrh; fo'ofo|ky;] ckWlokM+k ds fu;eksa dk iw.kZr% ikyu d#axk@d#axh] vuq”kklu
esa jgwWxk@jgwWxhA
4- ;g fd] lEcfU/kr fo”ofo|ky; }kjk esja k izos”k 75 izfr”kr mifLFkfr iw.kZ u fd;s tkus ds vk?kkj ij jÌ fd;s
tkus vFkok fo”ofo|ky; ijh{kk esa u cSBk;s tkus dh fLFkfr esa fo'ofo|ky; ij dksbZ okn] fdlh Hkh U;k;ky; esa
nk;j ugha d#Wxk@d#WxhA
5- ;g fd] fpfdRlk vodk”k@izlqfr vodk”k vFkok fdlh Hkh fdlh Hkh dkj.k ls esjh mifLFkfr fo”ofo|ky; ds
fu;ekuqlkj de gksus ij esa Loa; mŸkjnk;h jgwWxk@jgwWxhA
6- ;g fd] fo'ofo|ky; ds fu;eksa dk iw.kZr% ikyu d#axk@d#axh] vuq”kklu esa jgwWxk@jgwWxhA
7- ;g fd] xksfoUn xq: tutkrh; fo'ofo|ky;] ckWlokM+k esa lapkfyr fdlh Hkh ikB~Øe esa v/;;u ds nkSjku ;fn
eq>s fdlh Hkh ekeysa esa iqfyl@U;kf;d vfHkj{kk esa j[kk tkrk gSAvkSj bl otg ls esjh 75 izfr”kr mifLFkfr iw.kZ
ugha gks ikrh gS rk egkfo|ky; esjk izos”k fujLr dj ldrk gSA
8- ;g fd] orZeku esa ]EkSa fdlh Hkh ljdkjh@v/kZ ljdkjh@izkbZosV fyfeVsM+ dEiuh ;k fuft laLFkku esa ukSdjh ugh
dj jgk@jgh gwW vkSj uk osru@ekuns; ik dk;Z dj jgk gWAw
9- ;g fd] xksfoUn xq: tutkrh; fo'ofo|ky;] ckWlokM+k }kjk le;≤ ij tkjh funsZ”kks@vknsZ”kksa dh ikyuk
d#Wxk@d#WxhA
10- ;g fd] esjs fo:) dksbZ vkijkf/kd ekeyk fdlh Hkh U;k;ky; iqfyl Fkkus@U;k;ky; esa fopkjk/khu vFkok ntZ
ugh gSA }kjk eq>s dHkh Hkh nf.Mr ugha fd;k x;k@x;h gwWa vkSj u gh eSa tekur ij fjgk fd;k x;k@x;h gWWwA
11- ;g fd] eSaus xksfoUn xq: tutkrh; fo'ofo|ky;] ckalOkkMk ds vfrfjDr vU; fdlh fo'ofo|ky; esa izos'k ugh
fy;k gqvk gSA Lukrd@LukdksRrj fMxzh izkIr dh gSa rks 10 fnu ds vUnj ekbZxsz'ku izek.k&i= izLrqr
d:Wxka@d:Wx a hA
12- ;g fd] eSa jSfxax tSls vijkf/kd d`R; esa u rks iwoZ esa lafyIr jgk@jgh gwWa u gh Hkfo"; esa jgWx
w k@jgwWxh] ;fn eSa
fdlh Hkh izdkj dh jSafxax eSa lafyIr ik;k@ik;h tkrh gwW] rks esjk izos'k Lor% gh fujLr ekuk tk;sA
13- ;g fd] mijksä 'krksZa dk ikyu ugha djus dh fLFkfr esa xksfoUn xq: tutkrh; fo'ofo|ky;] ckalOkkMk esjk izos'k
fujLr djus ds fy;s LorU= gksxk rFkk eSa fdlh Hkh U;k;ky; esa bl laca/k esa dksbZ okn izLrqr ugha
d:Wxk@d:WxhA
fnukad gLrk{kj 'kiFkdrkZ

LFkku uke 'kiFkdrkZ

lR;kiu

eSa ---------------------------------------------------------------------------------------------------iq=@iq=h@iRuh Jh-------------------------------------------'kiFkiwoZd c;ku djrk

@djrh gWw fd mijksä c;ku 'kiFk i= esa of.kZr uke la[;k 1 ls 13 rd fyf[kr 'krZ iw.kZ lR; gS ,oa budk iw.kZ :Ik ls
ikyu d:Wxk@d:WxhA

fnukad gLrk{kj 'kiFkdrkZ