Modern Education Society' NOWROSJEE WADIA COLLEGE, Pune-411001 . "NAAC Accredited by 'A+'"
Contact: (020)-26162944, Tele-Fax: 26169108, www.nowrosjeewadiacollege.edu.in
Email address *
Student's Information Form
Specialization *
Class
Student Name *
In Block Letter (Surname-Name-Father's or Husband's name)
Your answer
Mother's Name *
Your answer
DOB *
Date Of Birth
MM
/
DD
/
YYYY
Email *
Your answer
POB *
Place of Birth
Your answer
Town *
Your answer
District *
Your answer
State *
Your answer
Mobile *
Your answer
Gender *
Martial status *
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 *
Your answer
Sub Caste *
(Put NA if not applicable)
Your answer
Category *
Caste Category
Fees concession *
If claiming concession for fees please check category
if Other (Specify)
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Religion *
Your answer
Nationality *
Your answer
Country *
Your answer
Address in Pune *
Address with Pin code
Your answer
Permanent Address *
If not a resident of Pune along with Pin Code
Your answer
Bank Account No. *
Your answer
Aadhar *
Your answer
Bank Name and Branch *
Your answer
IFSC Code *
Your answer
PAN No.
Your answer
I Passed the B. Sc. Examination. I give below information regarding the Examination. I have passed:
Name of college *
College name of the 12th standard
Your answer
Year *
Year of Passing of 12th Standard
Your answer
Seat No *
12th seat No
Your answer
Marks *
Total Marks
Your answer
Board *
University/Board
Your answer
State *
Your answer
B.Sc./M.Sc. college Name *
Your answer
University *
University of B.Sc college
Your answer
State: *
Your answer
Passing Year *
Passing year of B.Sc
Your answer
Exam Seat No *
Seat No Of B.Sc Exam
Your answer
Total Marks *
Total marks obtained in B.Sc Exam
Your answer
Grade *
Class/Grade obtained in B.Sc
Your answer
Guardian *
Name of Father/Guardian
Your answer
Relationship
In the case of Guardian Relationship with student
Your answer
Occupation *
Occupation of Parent/guardian
Your answer
Income *
Annual income of Parent/guardian
Address *
Address of Parent/Guardian
Your answer
Mobile No. *
Parent's Mobile Number
Your answer
Minority *
Are you belong to the Minority? Yes / No ( if yes please specify type which has given below)
Declaration
a) I have enclosed with this form : a. ORIGINAL COPY of the COLLEGE LEAVING CERTIFICATE which is NOT RETURNABLE to me if the admission is confirmed. b.Certified Xerox copy of the statement of XIIth / B. Sc.b) I hereby submit to the disciplinary jurisdiction of the authorities of the College and institute and shall observe and abide by the rules made by Principal of the College / Head of the Institution. I assure that the information supplied by me is correct to the best of my knowledge and belief.c) Further, I assure that I will not accept any full time or part time job anywhere while doing the course. If found, I am aware that my admission to the M. Sc. Course will be cancelled. *
ENDORSEMENT BY PARENT GUARDIAN *
1. The application is my son / daughter / ward and is seeking admission to your college with my 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 to principal in implementing the rules of the College and insisting on their observance in respect of my son / daughter / ward.
Student's Pledge
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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