admission form 2020 - government college nagrota bagwan
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GOVERNMENT COLLEGENAGROTA BAGWAN, DIST. KANGRA (H.P.) -176047
ADMISSION FORM (2020-21)
For Office use only
Fee Receipt No. ____________________________ Roll No. _____________________________
Date _____________________________________ Subject Allotted _______________________
Signature ____________________________
Attach Latest
Photograph
and
sign across
1. Name of Candidate (in block letters) _____________________________________________________
2. Father’s Name ________________________ 3. Mother’s Name __________________________
4. Gender (Male/Female) ___________ 5. Date of Birth (DD/MM/YYYY)
6. Course Name (BA / BSC / BCOM / MA /. Other ) _____________ 7. Year/Semester _____________
8. Category you belong to (General/ SC/ ST/ OBC/ IRDP (Attach Certificate)_________________________
9. University Registration No. ______________________ 10. Blood Group ______________________
11. Last Year College Roll No _______________________ 12. University Roll No. _________________
13. Student’s Email ID(Compulsory) __________________ 14. Aadhar Card No. ___________________
15. Bank Account No. _____________________ IFSC Code ____________ Branch Name ______________
16. Permanent Address ___________________________________________________________________
___________________________________________________________________
Phone No. (1) ___________________________ (2) ______________________________
17. Guardian’s Name & Address ____________________________________________________________
___________________________________________________________________
Phone No. (1) ___________________________ (2) ______________________________
18. Do you belong to Minority Community (Sikh/Muslim/Christian/Buddhist /Parsis / if other (mention) ________________
19. Name Class & Roll No of Brother / Sister Currently studying in the College ________________________
___________________________________________________________________________________
20. Academic Record (Attach Signed Copies of Certificates) 10+2 onwards
ExamPassed
Board/UniversityRoll No. Year Maximum
MarksMarks
ObtainedPercentage/CGPA
School/CollegeName
21. Subject Specific choice for 1st year students :
Subject 1 __________________ Subject 2 ____________________ Subject 3____________________
22. Course Combination (for 2nd Year and 3rd Year students) :
1_______________ 2_______________ 3_______________ 4_______________ 5_______________
23. Course Combination for M.A./M.Sc./M.COM. students :
1_______________ 2_______________ 3_______________ 4_______________ 5_______________
Student’s Email ID: ________________________ Phone No. _____________________
i) I am applying for admission with the approval of my parents / Guardian.ii) I will abide by the University/College rules and regulations. I have gone through the rules and regulations
regarding ragging and discipline of the University/College (given in the College Prospectus and hereby solemnly affirm that I will not indulge in any act of ragging/indiscipline and that if I an found guilty of such offences as are covered under these rules, the decision of the college authorities will be binding on me.
iii) All college dues will be paid in time.iv) I will be regular in my class and will compete 75% of the lectures delivered, failing which/will not be
entitled to take University examination.v) I will appear in the house examinations and fulfill all the conditions laid down by the University in this
respect.vi) I hereby promise not to take part in political activities of any kind as a student.vii) My admission will be provisional till approval by the University.
Date Signature of Applicant
DECLARATION BY THE APPLICANT
DECLARATION BY FATHER/GUARDIAN
I Father/Guardian of Mr. / Ms. _____________________________________________________solemnly
declare that my son/daughter/ward is seeking admission in class with my permission and I promise to pay all
dues regularly as and when demanded. He / She will not take part in any political subversive, agitations, ragging
activity or use any tobacco products in case he/she is involved in any of the above activities. I shall abide by the
action taken by the College authorities. I undertake the responsibility for the good behaviour and conduct of my
son/daughter/ward. I shall personally look after his/her regularity in attendance, progress in studies and general
behaviour and keep in touch with the Principal/Class Teachers regarding all these.
* (Guardian means only blood relation but not a student of this institution)
Date ..................................... Signature of Applicant Signature of Father/Guardian
(Before Admission Committee)
ANTI-RAGGING AFFIDAVIT
Vide H.P. University Notification No. 4-39/2012-HPU (Acad) dated 25th My, 2010, regarding curbing
menace of ragging in Educational Institutions, the parent of the students are required to submit the affidavit at
the time of admission containing undertaking as mentioned below :
I ___________________________ Father/Mother/Guardian of ____________________________
seeking admission to the class __________________ ensure you that my son/daughter/ward will not indulge in
any act of ragging or indiscipline in the college campus / hostel / anywhere outside the college campus in case of
any such violation strict disciplinary action may be taken against him/her as per the Ordinance issued by H.P.
Govt. and I will not interfere in any way in the action taken against my son / daughter / ward.
Date ________________________ Signature of Parent / Guardian
Certified that all the particulars mentioned in the form and other documents have been carefully checked from
original certificates and found in order and the applicant has signed before me. The applicant is
RECOMMENDED / NOT RECOMMENDED FOR ADMISSION.
Signature of Members 1 ___________________ 2__________________ 3___________________
Date _________________ Signature of Convener Signature of Principal/Convener
(Admission Committee) (Final Admission Committee)
(Admission / Provisionally Granted)
1. Father’s / Guardian’s Name ..........................................................................................
2. Occupation ..........................................................................................
3. Name of Student/Ward ..........................................................................................
(In Block Letters) ..........................................................................................
4. Class Roll No ..........................................................................................
5. Permanent Home Address ..........................................................................................
with Phone/Mob. No ..........................................................................................
6. Present Address of Father/Guardian ..........................................................................................
with Phone/Mob. No. ..........................................................................................
7. Father’s / Guardian’s Occupation ..........................................................................................
8. Name of Brother/Sister Studying ..........................................................................................
in the college (with Class & Roll No.) ..........................................................................................
UNDERTAKING
Kindly enroll me as a member of the Parent Teacher Association for the session 2020-21. I
promise to abide by the rules and regulations of the Association as at present and amended from time to
time. I also promise to attend all the meetings of PTA convened by the college authorities. My donations
of PTA are voluntary.
.................................................... ....................................................
Signature of Student Signature of Parent/Guardian
Note : i) Only parents can be member of PTA.
ii) Guardian means only blood relation but not a student of this college.
PARENT TEACHER ASSOCIATION(Govt. College, Nagrota Bagwan)
Membership Form
(2020-21)
Paste
Photograph
of Parents/
Guardians
Dist. Kangra (H.P.)
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