Faculty and Class in which admission is required:

Class :

Medium of Instruction :

Hindi

Scholar’s Name :

Date of Birth :

Father’s Name :

Father's Occupation :

Mother’s Name :

Monthly Income :

Local Address :

Permanent Home :

Guardian’s/Husband’s Name :

Religion :

Category ( ST, SC, OBC, GEN):

DECLARATION

I promise to abide by the Rules, Regulations and Orders of the college issued time to time. I also hereby declare that the details furnished above are correct to best of my knowledge.