Appendix C

 

SARDAR RAJINDER SINGH MEMORIAL

MUKAT COLLEGE OF EDUCATION FOR WOMEN

RAJPURA (PB) Ph 01762-322022

 

 

Admission Form For B.Ed. 2006-2007                     Form No: …………………………………

 

 

 

Space for

Passport Size Photograph

College Roll No. Alloted …………………………

 

                        B.Ed Entrance Test Roll No. ………………………....

                  

Marks ……………………. Position …………………

 

 

Category against which applied for admission (use√)          

 

  1. Name (in Block Letters) …………………………………………

 

  1. D.O.B ……………………………………….…………………….

(Candidates are advised to write their names according to their matric certificates)

 

  1. Father’s Name ……………………………………………. Occupation ……….………………

Income per month……………………………………………………..…………………………

 

  1. Mother’s Name …………………………………………… Occupation ………………………

Income per month………………………………………………………………..………………

(Married Candidates are advised not to write their Husbands name)

 

  1. (a) Permanent Address …………………………………………… Phone ……………………………

(b) Correspondence Address ………………………………………Phone ……………………………

 

      5.   Punjabi University Regd. No. …………………………………..Married/Unmarried…………………

 

      6.   At present Regd. With  ………………………………University………………………………………

 

      7.   Date of Birth (in figures) ……………………………………………………………………………….

                                    (in words) ……………….……………………………………………………………

 

  1. Employed: Yes/No

(if employed, attach No Objection Certificate from Employing Authority)

 

 

 

  1. Qualification:

 

Exam Passed

Board/

Uni

Name of Institution

Medium

Year

Roll No.

Max. Marks

Marks Obt.

% of marks

Subject Passed

Matric/Hr. Sec.

 

 

 

 

 

 

 

 

 

B.A/B.Sc.

Old Scheme

 

 

 

 

 

 

 

 

 

B.A./B.Sc. (10+2+3)

 

 

 

 

 

 

 

 

 

M.A./M. Sc.

 

 

 

 

 

 

 

 

 

Any Addl. Sub. passed in B.A.

 

 

 

 

 

 

 

 

 

Any Other Exam.

 

 

 

 

 

 

 

 

 

 

 

I agree to abide by the rules and regulations of the college and declare that:

 

1)      I was never disqualified by any University or Board.

2)      Information given by me in this form is correct to the best of my knowledge and nothing had been concealed.

3)      If found ineligible for admission by the Punjabi University at any time during the session, I shall be personally responsible for consequences thereof.

4)      I have attached attested copies of the following certificates:

  Matric Certificate                               Reserved Category Certificate                                

  B.A./B.Sc. Certificate                        Co-curricular Activities Certificate

  Pbi. U. Regd. Number                       NCC/NSS

  Character Certificate                          Zonal/Inter-zonal Youth Festival

 

 

           

Signature of the Father/Guardian                                                     Signature of the Applicant

            Date: ……………………..

 

UNDERTAKING

 

           

I, hereby undertake that in the event of taking admission in the college, if I leave the college after being  admitted, I will not claim any refund of fees, either through management or through court of law.

 

                                                                                                            Signature of the Applicant

 

 

 

 

 

FOR OFFICE USE ONLY

 

 

1.      Category of admission. ……………………………………………………

2.      Total Marks ……………………………………………………………….

3.      Certificate wanted (if any) ………………………………………………..

 

 

Received payment ……………………………………………………………..

Receipt No. ………………………………… Date ………….………………..

 

 

 

Signature of the Clerk                                                                 Signature of the Lecturer

 

                                                                  Admit.

                                                                  Principal