Form Fill up For BA/BSC -Multidisciplinary (MDC)

Day Shift
  Friday, 26 Apr 2024
PERSONAL INFORMATION
1. Name  
2. Date of Birth
Attach Your Passport Size Photo (Only JPG)

Size between 30KB to 50KB

  
Upload Student Signature (Only JPG)

Size between 10KB to 50KB
3. Nationality
4. Religion  
5. Minority
6. Gender   Kanyashree ID
7. Caste     Sub Caste
8. Physically Handicapped
9. Mobile No.
10. Aadhaar Card No.
11. Blood Group
12. Email id
13. ADDRESS
Vill
P.O.
P.S.
PIN Code
Dist.
State
14. Whether Working    
15. Mother Tongue    
16. Marital Status
17. Father's Name
18. Father's Qualification
19. Father's Occupation
20. Father's Income(Yearly)
21. Father's/Guardian's Phone No.
22. Mother's Name  
23. Mother's Qualification
24. Mother's Occupation
25. Mother's Income(Yearly)
26. Local Guardian's Name
27. Local Guardian's Occupation
28. Relation with Guardian
29. Legal Guardian
30. Banglar Siksha ID
Spouse Name
Anual Income of the Family    
Whether Belongs To Bpl / Apl    
Nearest Railway Station
Marks In Math(M.P)    
ACADEMIC RECORDS
H.S/Equivalent Roll & No./Index No.  
H.S Registration No.
Division
Year of Passing
Name of the Council/Board
Name of the School last Attended
Whether applied to some other college
Name Of The College Name Of the Course
Do you have CU Registration No?   CU Reg. No
 
Statement of marks obtained in the H.S./Equivalent Examination
                   * Do not enter the marks of Environmental Studies Unless it is Elective Subject
Please Select Subject Marks Obtained Full Marks
 Compulsory
EnglishCompulsory
 
 
 
 
 
                                 Total Marks Obtained                       Best Four Marks
 
APPLICATION PART
SHIFT  

All admissions are provisional. If any information is found incorrect the application/admission will be summarily cancelled without showing any reason whatsoever, at any point of time.
Srl. No.StreamSubject CombinationCC 1CC 2MinorIDC AECLCC 1LCC 2Combination CodeMerit Marks
1
Madhyamik Admit Card (Only JPG)
(admit/Certificate of Madhyamik)
Size between 100KB to 150KB 


 General(EWS) or Caste Certificate (Only JPG)
[if select any caste/General(EWS)]
Not more than 100kb 


 PWD Certificate (Only JPG)
(if select yes in ph category)
Not more than 100kb 


 H.S / Equivalent Marksheet. (Only JPG)Not more than 150kb 
Please confirm Date of Birth then submit your Application Form.
  
Full Address with Pin Code