(Established by Government of Gujarat vide Gujarat Act No.

9 of 2009 )

Student Registration Form

Postgraduate / Ph D (USE CAPITAL LETTERS TO FILL THIS FORM)
Name of College
Course
Admission Year Please affix
your recent
Surname passport size
Middle Name colour
Last Name photograph
Date of Birth
(DD/MM/YYYY)
E-mail ID Contact No
Guardian Contact No. Family Income (Yearly)
Students Category Admission Category
Gender Blood Group
Student Bank A/C No Aadhar Card Number
Present Address Permanent Address

Taluka City Taluka City

Dist. Pin Dist. Pin
Academic Details:

Examination Board/ Exam Seat No. of Passing Marks Percentile / Main GUJCET / JEE
Passed University No. trials Year Out of Percentage / Subjects Marks
OGPA / GRADE
SSC (10th )
HSC (10+2)
Undergraduate
Postgraduate
Documents enclosed:
Other Relevant Certificate
School Leaving Certificate Caste Certificate (If applicable)
(If any please specify)
SSC Marksheet Aadhar Card* 1)
First Page Photocopy of Bank
HSC Marksheet Passbook * (A/C, Name, IFSC 2)
code, Detail Bank Name)
Undergraduate Certificate* Medical Fitness Certificate 3)
Postgraduate Certificate* Fee Receipt *
4)
(only for Ph.D Students) (in University format)
Please note that fields with (*) are mandatory

________________ __________________ ________________________ ________________________

Student Signature Major Guide Signature HOD Signature Seal and Principal Signature
For official use only:

College Code
Registration 2 0 1
Number

Verified By Remarks -