Student Management System - Veetrag Swami Kalyanadev (PG) College

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Application Form

Veetrag Swami Kalyanadev (PG) College, Barla(Muzaffarnagar)
*Form for admission to Regular /Self Financing Courses*
Course	Class /Sem	Session

Optional Theory Subjects	Optional Pratical Subjects
	Below subject(s) will be selected automatically

Read the admission related information carefully before filling the admission form.

University Registration Number

Date Of Registration

For College Office Use Only
College Registration No :
Date :
Signature of clerk :

1. Name of Candidate (IN BLOCK LETTERS) (do not write Shri/Smt./Km./Ms./Dr. etc) * Mandatory Field
First Name	Aadhaar No.

2. Father's Name (IN BLOCK LETTERS) *	3. Mother's Name (IN BLOCK LETTERS)
4. Date Of Birth	5. Nationality

6. Sex

7. Category

8. Sub Category

9. Original Resident Of

10. Guardian's

Female

Male

Gen

OBC

PH*
Ex-Ser/DEP*
DEP F F*

(a) Occupation
(b) Income Per Annum

11. Address (IN BLOCK LETTERS)

Permanent Contact Details

Address *
City *	State *	Country *
PinCode	EmailID
Phone	Mobile *

Temporary Contact Details Copy Above

Address
City	State	Country
PinCode	EmailID
Landline	Mobile

12. Weightages Claimed

(a) Participation in sports	(b) Graduate From	(c) Son/Spouse/Dauhter of permanent employee of C.C.S university or its affiliated colleges	(g) Any other weightage/information
National Level	C.C.S University	(d) N.C.C./N.S.S	1.
State Level	Other University	(e) Scouts/Guides	2.
Interuniversity	Honours Degree	(f) Rovers Rangers	3.
Training certificate from sports authority of India (SAI)			4.

* Gen :General; SC : Schedule Caste; ST : Schedule Tribe; OBC : Other Backward Class ; PH : Physically Handicapped ; Ex-Ser/Dep. : Ex Service man / Dependent; Dep F.F. : Dependent of Freedom Fighter.

13. Qualification Information

14. Whether you were punished for any offence / unfair means committed by you in your previously attended or present institution. If yes, give details

15. If the result of the qualifying examination is not yet declared, submit a certificate from the head of institution to the effect that the candidate has appeared in all theory/practical papers of the qualifying examination.

Undertaking

1. I shall always obey in letter and spirit the rules and regulations formulated by the University and the College and shall be personally responsible for obeying the same.
2. That I shall not indulge in any activity that comes under indiscipline nor shall be involved in any action that has been declared against the conduct rules.
3. That at no stage I shall be involved in ragging and shall also cooperate in reporting any such matter to authorities if I come to know about this.
4. That I shall be personally responsible to complete my assignments and submit in time for assesment and evaluation.
5. That I shall ensure that I am regular and punctual in my classes and attempt to complete 100% attendance but not less than 75% under any circumstances.
6. That I am at present not student of any other college/University and shall not be appearing at any other examination leading to a degree.

I have read the aboce points carefully and shall be responsible for the following them.
I hereby declare that the information given in this application form is true to best of my knowledge and beleif. In case any information is found untrue, the university/college can cancel my Admission; for that no clain for refund of fee would be raised by me nor challenge in any court of law.

Dated :

Note:

1. No other person is allowed to sign on behalf of the application.
2. The applicant id required to enclose self attested photocopy of every relevant information related to academic record, age, reserved category, weightage (s), etc.
3. The applicant is also required to enclose any identity proof such as photocopy of 1 Card/Exam Admit Card of last exam passed/D.L./Pan Card/Bank Account Pass Book with photo.

For Admission Committee / Official Purpose:
1. Merit..............................................................Category: Gen/OBC/SC/ST.........................................................................................................
2. Weightage/s..................................................................................................................................................................................................
3. Remarks, if any..............................................................................................................................................................................................