PARVATHANENI BRAHMAYYA SIDDHARTHA COLLEGE OF ARTS & SCIENCE(Autonomous)                                                  
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 ADMISSION FORM
APPLICATION FOR ADMISSION INTO: *
1. Name in Full *
Date of Birth *
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Age in Years *
Gender *
Nationality *
Religion *
Mother Tongue *
Native Place *
Mandal *
District *
State *
Aadhar Card No. *
2.Hailed from *
3.Name of the Father/Guardian *
4.Name of the Mother *
5.Address for correspondence *
Permanent address with pin number
Address for correspondence *
Local address
Mobile *
Email id
6.Occupation of the Father/Guardian
Parent/Guardian Contact No. *
Occupation of the Mother
7.Educational Qualification/s of the Father
Educational Qualification/s of the Mother
Annual Family Income *
8.Category *
Other information
A copy of the relevant Certificate should be submitted.  
9.Admission sought *
Second Language Selected
Proramme *
Part III
Medium of Instruction *
10.Name of the Qualifying Examination passed: *
Regd. No. of the Qualifying Examination passed *
Medium of the Qualifying Examination passed *
Month and Year of the Qualifying Examination passed *
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11.Identification Marks *
Mention 2 Identification Marks as per X Marks Statement
12.CGPA obtained in the Qualifying Examination *
13.Particulars of the X Class *
Name of the institution and Place
Period of Study of the X Class *
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Particulars of the Intermediate *
Name of the institution and Place
Period of Study of the Intermediate *
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14.A)Proficiency in Co-curricular/ Extracurricular Activities
Like Sports, Games, Literacy, Cultural and Others(Mention Achievements Briefly)
B)Which Activity you like to pursue in the college
Like Sports, Games, Literacy, Cultural and Others
15.Do you require Hostel Accommodation *
16.Are you aspiring for any other professional course(Engineering, Medical etc.)
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