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    Nilesh Nagose
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    This document contains a student information form for a college seeking personal details of a student such as name, roll number, category, department, religion, caste, gender, date of birth, contact details, addresses, and family information including parents' education, occupation and contact details. The form requires the student's signature to declare the information is true and also signatures of parents.

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    This document contains a student information form for a college seeking personal details of a student such as name, roll number, category, department, religion, caste, gender, date of birth, contact details, addresses, and family information including parents' education, occupation and contact details. The form requires the student's signature to declare the information is true and also signatures of parents.

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    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
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    Download as docx, pdf, or txt
    22 views1 page

    Student's Information

    Uploaded by

    Nilesh Nagose
    This document contains a student information form for a college seeking personal details of a student such as name, roll number, category, department, religion, caste, gender, date of birth, contact details, addresses, and family information including parents' education, occupation and contact details. The form requires the student's signature to declare the information is true and also signatures of parents.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    of 1

    ALL INDIA SHRI SHIVAJI MEMORIAL SOCIETYS

    COLLEGE OF ENGINEERING, PUNE 1


    STUDENTS COUNSELLING CELL
    STUDENT INFORMATION

    Affix self
    attested
    passport
    size photo
    Name of Student: ______________________________________________________________
    Roll No: _____________________
    Category: _________

    Department / Branch: ________________________

    Religion: ______________

    Caste:

    __________________________

    Gender [Male / Female]: _______ State of Domicile: __________ Mother Tongue: __________
    Languages known: ______________________________________________________________
    Date of Birth: __________

    Blood Group: _______

    Landline No: __________________

    Mobile No: _____________________

    E-mail id: ____________________________________

    Local Address: ________________________________________________________________


    _____________________________________________________________________________
    Permanent Address: ____________________________________________________________
    ____________________________________________________________________________
    Fathers Information:
    Education: ______________

    Occupation: ______________ Designation: _________________

    Office Address: _________________________________________________________________


    ______________________________________________________________________________
    E-mail id: __________________ Mobile No.: ____________ Landline No.: ________________
    Mothers Information:
    Education: ___________ Occupation: _________________ Designation: _________________
    Office Address: ________________________________________________________________
    _____________________________________________________________________________
    E-mail id: __________________ Mobile No.: ______________Landline No.: _______________
    Name of local Guardian & address: ______________________________________________
    _____________________________________________________________________________
    E-mail id: ________________Mobile No.: ______________Landline No.: _______________

    I hereby declare that the above information as it relates to me is true and correct. I shall be responsible
    to inform to office for any in above information.

    Signature of Student
    *Please tick mark the address for correspondence

    Signature of Parents

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