ONLINE APPLICATION FORM
IMPORTANT NOTE
¼dsoy vHk;kFkhZ }kjk gh Hkjk tk;s vkSj Hkjus ls iwoZ vH;kFkhZ bl vkosnu&i= dks HkyhHkk¡fr i<+ ysa½
(To be filled by the candidate only and before filling the candidates are advised to go through carefully)
Application Form For Admission / izos”k gsrq vkosnu
  REGISTRATION DETAILS
Application Date/izkFkZuk&i= dh frfFk 
Class/d{kk
Subjects/fo’k;
  PERSONAL DETAILS
Name of Applicant / izkFkhZ dk uke *
Name of Father/Husband / firk@ifr dk uke   *
Name of Mother / ekrk dk uke
fookfgr@vfookfgr Marital Status
Mobile / Tel. No.
Email
Date of Birth / vH;kFkhZ dh tUefrfFk
¼gkbZLdwy ds izek.k&i= ds vuqlkj½
  fnu     ekg     o"kZ
Name, Address & Relationship with the guardian
if any / LFkkuh; vfHkHkkod dk uke] irk ,oa vH;kFkhZ
ls lEcU/k
Name / uke       
Address / irk       
Relationship / lEcU/k  
Name of the Institution Last Attended and
Examination Passed / vfrUe mRrh.kZ ijh{kk dk uke ,oa laLFkk
Marks Obtained / izkIrkad    Percentage / izfr"kr
Nationality / jk’Vªh;rk
Caste / tkfr
Give reasons for break in studies if any with proof /
i<+kbZ ;fn chp esa NwVh gS rks dkj.k ¼lizek.k½
  PERMANENT ADDRESS DETAILS
Address / LFkk;h irk
Village / xzke  
Post Office / Mkd?kj
Tehsil / rglhy
Block / Cykd
Police Station / Fkkuk
District / ftyk
  EDUCATIONAL QUALIFICATION
ijh{kk dk uke
Name of Examination
cksMZ@fo'ofo|ky;
dk uke

Name of Board/
University
laLFkkxr@O;fDrxr
vkSj mRrh.kZ djus
dk o'kZ

Regular/ Private
& Year of Passing
ijh{kk laLFkk dk
uke

Name of
Examination
Center
vuqØekad
Roll No.
fo"k; tks
fy;s x;s

Subject Offered
izkIrkadksa
dk ;ksx

Marks
Obtained
Js.kh ,oa vadksa
dk izfr"kr

Division &
Percentage
of Marks
gkbZLdwy rFkk led{k
High school or equivalent  
b.Vj rFkk led{k
Intermediate or equivalent
Lukrd
Graduation
,e0,0@ch0lh0,0
M.A./B.C.A.
vU;
Other

vH;kFkhZ }kjk vuqcU/k

eSa ,rn~}kjk ?kksf'kr djrk gw¡ fd mi;qZDr fooj.k lR; gS vkSj eSa Lohdkj djrk gw¡ fd esjk izos"k laLFkku ds fu;eksa] "krkZsa vkSj n"kkvksa rFkk N=ifr "kkgwth egkjkt fo"ofo|ky; dkuiqj dh lwph ;k vU; ifjorZu tks le;&le; ij lEcfU/kr izkf/kdkfj;ksa }kjk fd;s tkosaxs] ds vk/kkj ij vuqer gSA eq>s ;g Hkh fofnr gS fd bl vkosnu&i= esa fn, x, fooj.k vlR; ik, tkus ij esjk izos"k fujLr gks ldrk gS vkSj esjs }kjk tek dh xbZ "kqYd jkf"k tCr gks ldrh gSA

;fn esjh mifLFkfr 75 izfr"kr ls de gqbZ rks ijh{kk esa cSBus ls oafpr dj fn;k tkšxkA

;fn eSa laLFkku@fo"ofo|ky; esa fdlh vokafNr xfrfof/k jSfxax tSls d`R; ;k gM+rky vk;ksftr djus esa izR;{k ;k vizR;{k :i ls Hkkx yw¡xk ;k izsfjr d:¡xk] tks laLFkku ds vuq"kklu ds izfrdwy gksxk] rks esjk fuyEcu ;k fu'dklu gks ldrk gSA

 

I hereby declare that the foregoing particulars re correct and I agree that admission may be granted to me on the terms, conditions and rules of the institute and calendar of the chhatrapati Sahu Ji Maharaj University or such modification thereof as made by the authorities concerned from time to time. I understand that my admission may be cancelled and fee paid by me forfeited. If any of the particulars given by me in this application are subsequently found to be wrong.

I will not be allowed to appear in the examination in case my attendance stands below 75%.

My name may be rusticated or expelled from the institute if I directly of indirectly take part in any unwanted activities like ragging or strike in the institute/University.

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