Modern Education Society' NOWROSJEE WADIA COLLEGE, Pune-411001 . "NAAC Accredited by 'A+'"
Contact: (020)-26162944, Tele-Fax: 26169108, www.nowrosjeewadiacollege.edu.in
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Student's Information Form
Student's Name (As per S.S.C. Marksheet) *
Surname - First Name-Father's/Husband Name
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Mother's Name *
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Student's Date of Birth *
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Place of Birth *
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Town *
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District *
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Email ID *
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Mobile *
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Gender *
Married/Unmarried *
If you belongs to reserved category,state caste and category *
(If this col. is applicable to the student he/she should attach Xerox copy of the authentic caste certificate)
Caste *
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Sub-Caste *
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Caste Category *
If claiming concession for fees please check category *
if Other (Specify)
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Particular of Extra curricular Activity if any
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Religion and Nationality *
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Country *
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Address in Pune *
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Tel No. *
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Permanent Address is not a resident of Pune *
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Tel No. *
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Bank Account No. *
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Aaddhar Card No *
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Bank Name and Branch *
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IFSC Code *
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PAN No.
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B) I desire to offer following subjects
Compulsory Subjects *
Compulsory Subjects *
Compulsory Subjects *
Select any one of the following language and click on check box *
Select any FOUR of the following Subjects and click on check box *
Required
I Passed X-th std. Examination held in March _____ From _____ Centre,Under Seat No._____.I give the folowing information regarding examination i have passed.
Name of Exam passed *
X-th std or Equivalent Exam
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Name and Address of last School/College Attended *
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Year of Passing *
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Seat No *
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Total Marks obtained Out of *
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Class Obtained *
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Percentage *
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Other Information
Name of Father/Guardian *
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In the case of Guardian Relationship with student
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Occupation income of Parent/guardian *
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Annual income of Parent/guardian *
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Address of Parent/Guardian *
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Mobile No. *
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Declaration
I have Enclosed with this form: A) ORIGINAL SCHOOL CERTIFICATE WHICH IS NOT RETURNABLE to me if the admission is confirmed. B) Xerox copy of sttement of marks of the X-th Sc its equivalent examination duly attested. *
I have read all the rules and regulation of the college and of the H.S.C. Board,Pune and hereby agree if admitted ,to conform to them and to such other.rules as may hereafter be made by them form time to time.I promise that while i am a student of the college,I shall do nothing to obstruct or interfere in any way with its orderly government or discipline and that I shall devote my entire attention to the furtherance of my studies.I also promise that I shall inform the Principal in writing in case I decide to discontinue my education or change college in the middle of the year and clear all dues in respect of fees etc.I take full responsibility for the information supplied by me.I assure that the information supplied is correct to the best of my knowledge and belief.I am applying for F.Y.J.C. Science (std).XI Course *
Student's Pledge
1) On being admitted to the Jr. College,I undertake to abide by the discipline of the college and be guided by the college .2)I will be regular in attendance in my class throughout the year.I know that according to H.S.C. /board, pune rule,I shall not be eligible to appear for the Examination unless i put in 80% of the Attendance in the class *
ENDORSEMENT BY PARENT /GUARDIAN
1) The Applicant is my son/daughter/ward and is seeking admission to your college with consent. 2) I confirm the correctness of all the entries made in his/her application. 3)I have read the college rules and undertake to assist the principal in attempting the rule of the college and insisting on their observance in respect of my son/daughter/ward *
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