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    Dr. M. V. Shetty Memorial Trust Colleges: All The Columns Be Filled Up Properly

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    Nehasish Sahu
    This document contains an application form for admission to Dr. M.V. Shetty Memorial Trust Colleges. The form requests information such as the applicant's personal details, family details, academic qualifications, marks obtained in previous exams, and certificates to be enclosed. The applicant must declare that they will abide by college rules and regulations and pay fees on time. The form requires signatures of the applicant and parent/guardian to finalize the application.

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    Dr. M. V. Shetty Memorial Trust Colleges: All The Columns Be Filled Up Properly

    Uploaded by

    Nehasish Sahu
    27 views4 pages
    This document contains an application form for admission to Dr. M.V. Shetty Memorial Trust Colleges. The form requests information such as the applicant's personal details, family details, academic qualifications, marks obtained in previous exams, and certificates to be enclosed. The applicant must declare that they will abide by college rules and regulations and pay fees on time. The form requires signatures of the applicant and parent/guardian to finalize the application.

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    Application Form

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    This document contains an application form for admission to Dr. M.V. Shetty Memorial Trust Colleges. The form requests information such as the applicant's personal details, family details, academic qualifications, marks obtained in previous exams, and certificates to be enclosed. The applicant must declare that they will abide by college rules and regulations and pay fees on time. The form requires signatures of the applicant and parent/guardian to finalize the application.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    27 views4 pages

    Dr. M. V. Shetty Memorial Trust Colleges: All The Columns Be Filled Up Properly

    Uploaded by

    Nehasish Sahu
    This document contains an application form for admission to Dr. M.V. Shetty Memorial Trust Colleges. The form requests information such as the applicant's personal details, family details, academic qualifications, marks obtained in previous exams, and certificates to be enclosed. The applicant must declare that they will abide by college rules and regulations and pay fees on time. The form requires signatures of the applicant and parent/guardian to finalize the application.

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    DR. M. V.

    SHETTY MEMORIAL TRUST COLLEGES


    A. B. Shetty Circle, Mangalore 575 001, Karnataka Ph: 0824 2421953, Fax: 0824 2427897 (For office use) Reg. No. Details of payment : .............................................
    Affix recent self attested passport size colour photograph

    All the columns be filled up properly. Application for Admission to .............................................. Course Specialty preferred (for PG) 1) 2) 3) Year 200 - 200

    Full Name of the applicant (Block Letters

    Date of Birth in Indian Almanac

    Place of Birth Male

    Sex Female

    Father's details : (Block Letters) Name: Occupation: Annual Income:

    Mother's Details (Block Letters) Name: Occupation: Annual Income:

    Permanent Address: (Block Letters) ........................................................... ........................................................... ........................................................... Pin Code : STD Code : Phone : ........................................................... Email:

    Present Address / Telegraphic Address : (Block Letters) ........................................................................ ........................................................................ ........................................................................ Pin Code : STD Code : Phone : ...................................................... Email:

    Guardian if father is not alive Name & Address

    Relation :................................ Occupation:................................. Income:............................... Nationality Religion Caste OBC Group SC/ST

    Candidate's marital status (Tick ) Married Unmarried

    Mother Tongue

    Native / Domicile of Karnataka


    Yes No

    State: Eligibility Certificate applied


    Yes No

    Whether Attested Copies of marks cards and other certificates enclose Yes No

    Academic Particulars
    Exam passed a) 10th Name & Address of School/College Name of Reg. No. Class Year and Board/Uni. passed month of passing Private or regular If VHS, subject

    b) P.U.C. Or 10 + 2

    c) Degree

    d) Any other exam

    Details of 10+2 Marks obtained in science subjects


    Subjects Max Marks Marks obtained Percentage Total of all subjects Max. Marks Physics Chemistry Biology Maths Botany Zoology Computer Science Total Marks obtained

    Details of Degree : (For P.G. Course) Marks obtained


    All Subjects Maximum Marks Marks Obtained

    Name of Degree:

    Percentage

    Total of all subjects Max Marks Marks obtained

    General / Languages Optional Subjects

    Total

    Details of the fees paid: 1. Application fee of Rs.300.00 PAID 2. Registration fee of Rs.200 PAID
    DD No. Date: Bank:

    Attested copies of the certificates to be enclosed (Tick )


    Enclosed S.S.L.C. / 10th Marks card of 11th Std. If the exam is conducted by the Board/University Certificate from the Principal of the college that he/she was a regular student of 11th & 12th and that there is no examination for 11th year conducted by the University /Board (if not conducted) (for BASLP course only) P.U.C./10+2 marks card. Pass Certificate Transfer Certificate Conduct Certificate Migration Certificate Marks card of Degree (for P.G. Course only) Degree Certificate of Provisional pass certificate issued by the University (for P.G. Course only) For Nepalese-Nepalese Citizenship Certificate or Passport. Date of birtht in Indian Almanac (A.D.) for Nepalese. Foreign countries students Passport and student visa. Note: All original certificates should be produced at the time of admission Not Enclosed

    DECLARATION BY THE CANDIDATE I hereby state that I have filled this form myself, and to the best of my knowledge and belief, the particulars given above are t rue. I hereby undertake to abide by all the conditions, rules and regulations in force at present and also those which may hereafter be introduced for the administration of the College. I will do nothing unworthy of a student of the college either inside or outside or anything that will interfere with its orderly working and discipline. I am aware that the management has the full authority to expel me for interest in studies, misbehavior, continuous failures and for any other valid reasons. I hereby undertake that I shall pay all the fees and other dues to the institution promptly on demand. I have thoroughly read the prospectus and understood the contents of it. I shall pay the College fees for the whole course period if I withdraw from the college anytime after admission and before completion of the course. Place: Date: Countersigned Signature of the applicant

    Signature of the Parent / Legal Guardian (if parents not alive)

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