Application No.

Registration No.

C.M.S. COLLEGE OF SCIENCE & COMMERCE

PHOTO

Application form for Admission to PG Courses

(All entries in capital letters)
1.

Course Applied

Name of the Applicant

3.

Sex (Put Tick Mark)

4.

Date of Birth (in words & figures)

5.

Religion & Caste

6.

Nationality

7.

Community (Put Tick Mark)

8.

Blood Group

9.

Fathers or Guardians Name (State Relationship)

10.

Fathers Occupation

11.

Mothers Name

12.

Mothers Occupation

13.

Family Income per annum

14.

Mother Tongue

15.

Languages Known

16.

If, Physically Handicapped, specify

17.

Are you son/daughter of ex-service man

18.

Distinction in Sports / NCC / NSS

19.

Extra Curricular Activities

20.

Any other Achievements

21.

Name and Location (District ) of College last studied

22.

Is Hostel Accommodation required? (Put tick mark)

23.

Permanent Address and Telephone Numbers with STD Code

PIN:

Male
D

OC

BC

F
M

MBC/OBC

Yes

Female
Y
Y

SC

ST

No

Address for Communication and Telephone

Numbers with STD Codes

PIN:

Phone:

Phone:

26.

Reference if any

27.

Details of Qualifying Examinations Passed*

Subject

Marks
Obtained

Max.
Marks

Month &
Year of
Passing

Reg.
No.

University

No of
attempts

Part I Language
Part II English
Part III*
Main
ANC I
ANC II
ANC - III
Total Marks

Overall Percentage:

*Photocopy of the Mark List to be attached

DECLARATION
The above information is true and correct to the best of my knowledge. I agree to be
governed by the rules and regulations of the college.

SIGNATURE OF THE PARENT/ GUARDIAN

SIGNATURE OF THE APPLICANT

Place :
Date :

FOR OFFICE USE ONLY

Certificates Verified: (Put Tick Mark)

Date of Admission:
Fee Receipt No. and Date:

HSC Marks

Community

Transfer

Conduct

Spl.Category

Others

Signature of the Staff who processed the Application:

ADMITTED

Signature of the Head of the Department

PRINCIPAL
*Application fee shall be paid along with semester fee .