Form No:
सरयुग महाविद्यालय, चित्रगुप्त नगर, मोहनपुर समस्तीपुर बिहार Saryug College Chitragupt Nagar, Mohanpur, Samastipur Bihar (848101) Website: www.saryugcollege.com Application For Admission |
| INSTRUCTION: Candidate should fill in the form neatly and legibly in English in own hand writing in BLOCK LETTERS using blue/black ball pen only and ( * ) denote mandatory information निर्देश: उम्मीदवार को केवल नीले / काले बॉल पेन का उपयोग करके BLOCK LETTERS में स्वयं लेखन में बड़े करीने से और कानूनी रूप से अंग्रेजी में फॉर्म भरना चाहिए और ( * ) अनिवार्य सूचना को निरूपित करना चाहिए |
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For Office Use
Admission Receipt No:
Date:
Class: _______________________ Faculty: _______________________ Roll No: Signature |
Please affix
your Recent front side Passport Size Color Photograph |
| I sought to take admission in.......................................................................................Class of your institution during the session ........................................................... |
| मैं आपके महाविद्यालय के सत्र............................................................................................के...............................................................................वर्ग में नामांकन करना चाहता हु | |
| Personal Details : |
| Name of Candidate * छात्र / छात्रा का नाम |
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| हिंदी में * | _______________________________________________________________________________________________________________________ |
| Mother's Name * माता का नाम |
| Father's Name * पिता का नाम |
| Guardian's Name * अभिभावक का नाम |
| Occupation of Father/Mother/Guardian * पिता/माता/अभिभावक का व्यवसाय |
__________________________________________________________________________________________ |
| Date of Birth * जन्म-तिथि |
Gender: * लिंग |
Male Female Other |
| Caste (If Freeship Claimed) जाति (यदि शुल्क में छूट चाहते है) |
____________________________________________________________________________________________________ |
| Permanent Address (स्थायी पता) : |
| Permanent Address * स्थायी पत्ता |
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| Current Address * वर्तमान पता |
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| State * राज्य |
Nationality * राष्ट्रीयता |
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| Religion * धर्म |
Caste जाति |
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| Mother Tounge मातृ भाषा |
Category * वर्ग |
General EWS BC-I BC-II SC ST Others | |||
| Mobile No. * मोबाइल नं. |
Tel No |
OFSS Code | |||
| Email ID |
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| Aadhaar No. * आधार सं. |
Pin Code पिन कोड |
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| Account No. बैंक खाता सं. |
IFSC Code Branch Name ______________________________ | ||||
| Other Information if any special claim for admission अन्य सूचना यदि प्रवेश के लिए कोई विशेष दावा किया जाता है तो | _____________________________________________________________________________________ |
| ___________________________________________________________________________________________________________________________________ | |
| Details of Matric or Equivalent Examination Passed (मैट्रिक या समकक्ष पास किये गए परीक्षाओं का विवरण) |
| Class (कक्षा) |
School स्कूल |
Board बोर्ड |
Seat No. सीट नं. |
Year of Passing वर्ष |
Month महीना |
Total Marks कुल मार्क |
Percent प्रतिशत (%) |
|---|---|---|---|---|---|---|---|
| Subject Offered (दिए गए विषय): |
| 1. Compulsary Subject (Select any one subject - each 100 marks)* | ||
| Hindi - English - | ||
| 2. Optional * | ||
| 1. ________________________________ | 2. ________________________________ | 3. ________________________________ |
| 3. Additional *________________________________ | 4. Vocational *________________________________ | |
| Declaration : |
| I.......................................hereby declare that |
| 1. The information given above here in this application is true to the best of my knowledge and belief. |
| 2. The documents attached are true photo copies of original one. |
| 3. My admission is liable to cancel, if any information or documents found false or fabricated at any stage of my study and college will initiate legal procedure against me. |
| 4. I shall be A bride with rule and regulations of the college. |
| Date: तिथि | Signature of Applicant (In English) अभ्यर्थी के हस्ताक्षर (अंग्रेजी में) | Signature of Parents (In English) माता/पिता के हस्ताक्षर (अंग्रेजी में) |
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| Documents to be attached: 1. SLC 2. Xerox of Marksheet 3. Xerox of Admitted 4. Cast Certificate and Income Certificate, if required. 5. Two Passport size photograph for Identity Card. 6. OFSS Intimation Letter. 7. Xerox of Bank Passbook. 8. Xerox of Aadhar Card. |
| OFFICE ORDER |
| Admission In charge | Principal |