I Choose the following subjects for my course. Class:

Sr. No. ArtS/ CommerCe/ SCIeNCe/ BBI/ BmS/ Comp.Sc./ I.tSem I/ Sem III/ Sem V Sem II/ Sem IV/ Sem VI

Details of previous examinationClass : Month & Year of examination

Sr. No. Subject marks/ Grade obtained out of marks

I have read the rules of the college and do hereby undertake, if admitted, to abide by them as they are at present in force and as they hereafter be made by the college authorities.

Yours obediently,

(Signature of the student)

Checked by:

remArK-

Date: / / 2018 PrINCIPAl

Documents requiredFIrSt YeAr SeCoND YeAr tHIrD YeAr

HSC Marksheet (2 Copies) Sem I & Sem II Marksheet (Photocopy) Sem I to Sem IV Marksheet (Photocopy)SSC Board certificate (1 Copy) Aadhar Card Aadhar CardLeaving Certificate (Photocopy & Original) Not Applicable for Inhouse Student.

Caste Certificate (If Applicable) Caste Certificate (If Applicable)

Aadhar Card Yuva Raksha Form Yuva Raksha FormCaste Certificate (If Applicable) Sport Profile Sport ProfileOnline Registration from Print Fee concession documents (if any) Fee concession documents (if any)Yuva Raksha FormSport ProfileFee concession documents (if any)

Recommendation of theAdmission Commitee

Place : DevgadDate : / /

"YUVA RAKSHA"(GROUP INSURANCE SCHEME FOR STUDENTS)

STUDENTS REGISTRATION FORM(Copy to be submitted along with the Admission from)

1. Name of the Insured (Student) :

2. Class :

3. Residential address :

4. Student's date of Birth :

5. Blood group :

6. Name of the guardian :

7. Signature of the guardian :

8. Amount of premium paid in :cash or in cheque

Student's singature

For Office use only-

Received from student (name) - of

premium of Rs. 40/- (Rupees Forty Only) against the receipt no.

Dated :

Institute/ Department/ College Seal/ Stamp with signature(College to preserve the slip along with admission form)

NATIONAL INSURANCE COMPANY LIMITED