College Admission Form

Name of applicant in block letters as in degree certificate *

Prefix First Name Middle Initial Last Name
Permanent Address *

Street Address

Street Address Line 2

City State

Zip Code Country
Address for correspondence *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Aadhar Number *
Email Id *
example@example.com
Place of Birth *
Date of Birth *

Day Month Year
Mobile Number *
Caste *
Sub caste *
Religion *
Nationality *
Name of the college, where Graduation was done *

Details of EDUCATIONAL QUALIFICATION *

Application Fee Receipt No.
1. I undertake to abide by the rules and regulations stipulated by the Government of Karnataka, Bangalore University and the institution.
2. During the tenure of the course, I am willing to participate in educational tours, sports, games and other healthy practices.
3. I declare that all the information furnished in the application form are true.
Place *
Date *

Day Month Year
Signature of Applicant *

Clear
I agree to pay all the prescribed fees and own the responsibility for the conduct and discipline of my son / daughter. I am aware that the student who does not adhere to rules and regulations will be subject to disciplinary action.
Place *
Date *

Day Month Year
Signature of Father / Husband *

Clear
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FOR OFFICE USE ONLY

Office note regarding fees paid:

Payment Mode:

Receipt No:

Date :

Manager
Should be Empty: