Modern Education Society' NOWROSJEE WADIA COLLEGE, Pune-411001 . "NAAC Accredited by 'A+'"
Contact: (020)-26162944, Tele-Fax: 26169108,
Email address *
Student's Information Form
Student Name *
In Block Letter as per 10th Mark sheet
Your answer
Mother's Name *
Your answer
Date Of Birth
Email *
Your answer
Place of Birth
Your answer
Town *
Your answer
District *
Your answer
State *
Your answer
Mobile *
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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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Particular of Extra curricular Activity if any
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Religion *
Your answer
Nationality *
Your answer
Country *
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Address in Pune *
Address with Pin code
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Permanent Address *
If not a resident of Pune along with Pin Code
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Bank Account No. *
Your answer
Aadhar *
Your answer
Bank Name and Branch *
Your answer
IFSC Code *
Your answer
Your answer
B) I desire to offer following subjects
Compulsory Subject *
Following are the Compulsory subjects
Vocational Subject *
Select any one *
For vocational select NA
Select any two *
Geography and Geology can not be selected together
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 *
Name of Exam passed
Name and Address of last School/College Attended *
Your answer
Year of Passing *
Seat No *
Your answer
Marks *
Total Marks
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Out of
Marks out of
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Class *
Class Obtained
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Percentage *
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Other Information
Guardian *
Name of Father/Guardian
Your answer
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
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 statement of marks of the X-th Science 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 *
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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