ADMISSION FOR THE ACADEMIC YEAR 2021-22 Upload Student Photo: * Name of the Applicant (as per 10th marks card): Date of Birth: Gender: MaleFemale Mother Tongue: Nationality - Indian / Other (Specify): Religion: Category: SCSTCat-IIIAIIBIIIAIIIBGen Last College attended (Name): Mobile Number: Email Id: Aadhar Card Number: Extra Curricular Activity (Mention with comma separated): DETAILS OF PREVIOUS EXAMINATION PASSED Month & Year of Passing: State from which passed: Medium of Instruction: Registration No.: Total Marks: Percentage of Marks: Name of the Board: Subjects offered in previous exams with marks (Mention with comma separated): Subjects offered at BCA (Mention with comma separated): FATHERS DETAILS Fathers Name: Fathers Mobile Number: Fathers Occupation: Fathers Email Id: Fathers Annual Income: MOTHERS DETAILS Mothers Name: Mothers Mobile Number: Mothers Occupation: Mothers Emial Id: Mothers Annual Income: Permanent Address of the Parent / Guardian: Original Documents Submitted: S.S.L.CPUCEligibilityCaste / Income Certificate only for SC / ST and Cat-I DECLARATION OF THE APPLICANT I have read and i am fully conservant with all the rules & regualations of the college printed in the prospectus. DECLARATION OF THE PARENTS / GUARDIAN I am aware that the institution has the right to cancel the admission of my son / daughter / Ward for his / her any act of indescipline. Place: Date:
