Modern Education Society' NOWROSJEE WADIA COLLEGE, Pune-411001 . "NAAC Accredited by 'A+'"
Contact:  (020)-26162944, Tele-Fax: 26169108, www.nowrosjeewadiacollege.edu.in
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Email *
Student's Information Form
Student Name *
In Block Letter as per 10th Mark sheet
Mother's Name *
DOB *
Date Of Birth
MM
/
DD
/
YYYY
Email *
POB *
Place of Birth
Town *
District *
State *
Mobile *
Gender *
Martial status *
If you belongs to reserved category,state caste and category *
(If this col. is applicable to the student he/she should attach Xerox copy of the authentic caste certificate)
Caste *
Sub Caste *
(Put NA if not applicable)
Category *
Caste Category
Fees concession *
If claiming concession for fees please check category
if Other (Specify)
Particular of Extra curricular Activity if any
Religion *
Nationality *
Country *
Address in Pune *
Address with Pin code
Permanent Address *
If not a resident of Pune along with Pin Code
Bank Account No. *
Aadhar *
Bank Name and Branch *
IFSC Code *
PAN No.
B) I desire to offer following subjects
Compulsory Subject *
Following are the Compulsory subjects
Vocational Subject *
Select any one *
For vocational select NA
Select any two *
Geography and Geology can not be selected together
Required
I Passed X-th std. Examination held in March _____ From _____ Centre,Under Seat No._____.I give the folowing information regarding examination i have passed.
Name of Exam *
Name of Exam passed
Name and Address of last School/College Attended *
Year of Passing *
Seat No *
Marks *
Total Marks
Out of
Marks out of
Class *
Class Obtained
Percentage *
Other Information
Guardian *
Name of Father/Guardian
Relationship
In the case of Guardian Relationship with student
Occupation *
Occupation of Parent/guardian
Income *
Annual income of Parent/guardian
Address *
Address of Parent/Guardian
Mobile No. *
Parent's Mobile Number
Declaration
I have Enclosed with this form: A) ORIGINAL SCHOOL CERTIFICATE WHICH IS NOT RETURNABLE to me if the admission is confirmed. B) Xerox copy of statement of marks of the X-th Science its equivalent examination duly attested. *
I have read all the rules and regulation of the college and of the H.S.C. Board,Pune and hereby agree if admitted ,to conform to them and to such other.rules as may hereafter be made by them form time to time.I promise that while i am a student of the college,I shall do nothing to obstruct or interfere in any way with its orderly government or discipline and that I shall devote my entire attention to the furtherance of my studies.I also promise that I shall inform the Principal in writing in case I decide to discontinue my education or change college in the middle of the year and clear all dues in respect of fees etc.I take full responsibility for the information supplied by me.I assure that the information supplied is correct to the best of my knowledge and belief.I am applying for F.Y.J.C. Science (std).XI Course *
Student's Pledge
1) On being admitted to the Jr. College,I undertake to abide by the discipline of the college and be guided by the college .2)I will be regular in attendance in my class throughout the year.I know that according to H.S.C. /board, pune rule,I shall not be eligible to appear for the Examination unless i put in 80% of the Attendance in the class *
ENDORSEMENT BY PARENT /GUARDIAN
1) The Applicant is my son/daughter/ward and is seeking admission to your college with consent. 2) I confirm the correctness of all the entries made in his/her application. 3)I have read the college rules and undertake to assist the principal in attempting the rule of the college and insisting on their observance in respect of my son/daughter/ward *
FOR OFFICE USE ONLY
Kindly Select the following option "Send me a copy of my responses". Note: Once you Submit the form you can't Re-edit/Re-submit the Form
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