Managed By: Vanita Vishram, Surat

SHETH P.T. MAHILA COLLEGE OF ARTS & HOME SCIENCE

(Affiliated to Veer Narmad South Gujarat University, Surat)

(Recognized Under Sections 2(f) & 12(b) of UGC Act, 1956)

Vanita Vishram, Athwagate, Surat-395001, 0261-2300254

Email: office.sptmc@gmail.com, Website: www.sptmc.in

APPLICATION FORM FOR ADMISSION TO FIRST YEAR (SEMESTER I &

II)

Academic Year : 2022-23

APPLICATION FOR ADMISSION TO ARTS
Form No: AQ2217000037
(USE CAPITAL LETTERS ONLY   PUT (✔) MARK IN THE BLOCK)

To,

The Principal

Sheth P.T. Mahila College of Arts & Home Science

Vanita Vishram, Athwagate, Surat

Respected Sir/Madam,

I apply for admission to your college and given below the necessary particulars.
I agree to pay full fees and
deposite as
per the norms, if the admission is granted.

(1) Name of the Student : Lohar Damini Rajendra

(Surname) (Name) (Father's Name)
(2) Address for Correspondence : 04,SANJAYNAGAR ,
SU NO.48, LIMBAYAT,
SURAT, , -394210

(3) Contact Details:(R) : 9265326173 E-mail (Student): rahulgadilohar99@gmail.com

(Mob. – Student) : 9265326173 (Mob. – Father): 9924861127 (Mob. – Mother): 9924861127
(4) Birth Date : 25-Mar-2003 Age: 19 Native Place: Nationality: INDIAN
(5) Religion: Hindu
✔   Muslim
   Sikh
   Jain
   Parsi
   Christian
   Buddhist
   Other
  

Caste: HINDU GADI LOHAR Sub Caste:

(6) Aadhar Card No.:

(7) Category
General
✔   OBC
   SEBC
   SC
   ST
   EBC
   Minority
   EWS
  
(8) Father's Name : LOHAR RAJENDRA CHINDU Profession : BUSSINESS
Annual Income (Rs.) : Less than 1,00,000
(9) Mother's Name : LOHAR MAYA RAJENDRA Profession : HOUSEWIFE
Annual Income (Rs.) : N.A.
(10) School / College Last Attended : SARASWATI HIGH SCHOOL
(11) Passed H.S.C. with Medium : Gujarati
   English
   Hindi
  
(12) Details of Board Examinations:

Year of Marks
Examination Board Marks Out of Percentage / CGPA Trial
Passing Obtained
HSC 2018

(13) In addition to the curriculum, I will opt.(Tick only One)

NCC
  
NSS
  
Saptadhara
✔  
PT
  
(14) I
have
not
applied for an accommodation in Vanita Vishram Hostel.
Subjects : I would like to select following principal and subsidiary Subjects.
Foundation Compulsory
Gujarati
✔ Hindi
English

Foundation Elective ✔ Environmental Studies - Gujarati Medium

Core Allied ✔ Sanskrit Elements of statistics - Gujarati Medium

Core Compulsory Gujarati ✔ Hindi

Core Elective Gujarati Hindi English ✔ History - Gujarati Medium

➱ I assure you that information given in the form is correct and true to the best of my
knowledge.
➱ I have read the rules and regulations given in the College Prospectus and I agree to abide by
them.
➱ I solemnly promise to maintain the Code of Conduct as laid down in the College Prospectus and
will
follow all the
rules and regulations of the College & University that may come into force from time to
time.
➱ I shall not approach any staff member of the college for private coaching.
➱ I understand that fees once paid will be refunded only as per the norms of the University.
➱ I shall not join any institution / organization for study or service during college hours.
College is
liable to take any
disciplinary action against me under the given circumstances.
➱After taking admission to the college, if I pass any state/national/international level
competitive
examination or
secure rank in any state/national/international level competition, I will inform about
the same
to the college
authorities.
➱ I shall inform about the change in address of correspondence to the college admin office
during my
course of study
in the college.

Important Note:

➱ Download College Prospectus from the college website www.sptmc.in for more
details.
➱ It is compulsory for the students and parents to attend Orientation Programme after taking
admission
as well as
attend all Parents-Teachers Meeting, as and when required.

Place :

Date :
01-Jan-2023 Signature of the Student Signature of the Parent

Admission Committee Help Centre In-charge Signature of the Principal

Documents Needed for Uploading the Application Form:
➱ Recent Passport Size Photograph (Max. Size 150 kb)
➱ HSC Mark-sheet
➱ Bank Passbook
➱ Passing Certificate
➱ School Leaving Certificate
➱ Transfer Certificate (Applicable to the Students of Board other than GSHEB)
➱ Caste Certificate (SC/ST/SEBC/OBC)
➱ Non-Creamy Layer Certificate (SEBC/OBC)
➱ Income Certificate (SEBC/OBC/EWS)
➱ Divyang Certificate (For Divyang Students Only)
➱ Aadhar Card

Documents to be Attached While Submitting the Application

Form:
➱ Duly Filled & Signed College Application Form (1 Copy)
➱ ORIGINAL HSC Mark-sheet (1 Copy)
➱ Recent Passport Size Photograph (3 Copies)
➱ Self-attested Xerox of Bank Passbook (1 Copy)
➱ Self-attested Xerox of HSC Mark-sheet (1 Copy)
➱ Self-attested Xerox of Passing Certificate (1 Copy)
➱ Self-attested Xerox of School Leaving Certificate (1 Copy)
➱ Self-attested Xerox of Transfer Certificate (1 Copy)
(Applicable to the Students of Board other than GSHEB) (1 Copy)
➱ Self-attested Xerox of Caste Certificate (SC/ST/SEBC/OBC) (1 Copy)
➱ Self-attested Xerox of Non-Creamy Layer Certificate (SEBC/OBC) (1 Copy)
➱ Self-attested Xerox Income Certificate (SEBC/OBC/EWS) (1 Copy)
➱ Self-attested Xerox of Divyang Certificate (For Divyang Students Only) (1 Copy)
➱ Self-attested Xerox of Aadhar Card (1 Copy)
➱ Sports Certificates (If admission is taken under Sports Quota)
(Self-attested 1 Set of All Certificates)