Admission Request Form 2015-16

Transcription

Admission Request Form 2015-16
Form no
MAH-MBA-CET-15/
Receipt No.---------------
G. H. RAISONI COLLEGE OF ENGINEERING, NAGPUR
(An Autonomous Institute by UGC Act & Affiliated to RTM Nagpur University)
Date
ADMISSION REQUEST FORM
MBA First Year - 2015-16
(Minority Seats)
Affix recent
passport size
photograph
Demand Draft Details:
Amount: 1000/-DD. No. -------------------- D.D. Date: ------------------------------Bank Name: ---------------------------------------- Branch: ------------------------Name of the Candidate:
(First name, Father’s name and surname in capital letters)
Mother’s name:
Address for communication:
City:
Pin Code:
e-mail address:
Phone number :( R)
Mobile:
Mother Tongue:
Gender: Male
Mobile:
Religion:
Female
Date of Birth:
State of Domicile:
Examination Passed
Nationality:
Caste Category: SC/ST/VJ/NT/OBC/General
Name of the
Max.
Board /
University
Marks
Marks
Percentage
Obtained (Aggregate)
Month
&Year of
Passing
SSC
HSSC
Graduation Degree
(Specify)
Studied English subject at Degree level (YES/NO) 
Details of Entrance Examination
State Merit No.
Application ID
Roll No.
Score
MAH-MBA-CET -2015
Kindly consider my Admission Request Form for preliminary scrutiny and the preparation of merit list for Minority quota
seats. I shall complete the necessary formalities required as per the procedure as and when declared/ published.
Information furnished by me in this application is true to the best of my knowledge and belief.
Signature of Candidate:
Date
Note: Incomplete applications in any case will not be processed.
Please attach attested Photo copies of required document.
-----------------
I have enclosed the following attested Photo copies of document.
Sr.No
Documents
Please
Tick
1
S.S.C. (Std. X) mark sheet.
2
3
4
H.S.C. (Std. XII) mark sheet.
Graduation Mark sheets (I/ II / III ) YEAR
College leaving certificate after passing Graduation.
5
6
Certificate of the Indian Nationality of the candidate.
Statement of marks for the Bachelor’s Degree Examination (i.e. the qualifying degree)
7
Migration Certificate (if required)
8
Gap Certificate on 50 Rs. Stamp paper if Graduation Examination passed in 2014-15 or before
9
10
MAH-MBA-CET-2015 Score Card
Eligibility Certificate ( if required)
11
Domicile certificate of candidate indicating that he/she is domiciled of which State
12
13
Hindi Knowing Affidavit at the time of admission.
Any Other
DECLARATION TO BE SIGNED BY THE APPLICANT
I-----------------------------------------------------------------------------------------------------------declare that:
The information given by me in this application is true to the best of my knowledge and belief.
I have filled this application form for the consideration of admission to M.B.A. First Year through Minority Quota.
Date:
/
/2015
Place: Nagpur
Signature of Candidate
DECLARATION TO BE SIGNED BY THE PARENT/GUARDIAN
I-----------------------------------------------------------------------------------------------------------declare that:
The information given by my s o n /daughter/ward in this application is true to the best of my knowledge and
belief. I will sign requisite affidavit / bond as prescribed by the Authority for minority candidates.
Date:
/
/2015
Place: Nagpur
Signature of Parent/Guardian
ACKNOWLEDGEMENT:-
Received dully filled ARF No.
--------- of Mr. ------------------------------------------------------towards First Year MBA
Admission (2015-16) to GHRCE. You are requested to visit our college website http://ghrce.raisoni.net
for detail rules and schedule regarding admission process.
Date: …/…/2015
Signature
G.H.R.C.E., Nagpur