GOVT. V.Y.T COLLEGE DURG

NEAR RAIPUR NAKA DURG C.G. .

Admission Form

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Parent Details

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Academic Details

(From 10th to Latest Qualifying Exam)
SI.NO. Name Of Exam Board/University Name of Institution Roll No Year Marks Obtained Total Marks Division & Percentage
1*
2*
3
4
5
6
7
8
9
10

Total Percentage of the Qualified Examination Main Subject

Extra Curricular Activities, If So Give Details

School Level State National International Attachment
Sports
Cultural
Literary
NCC
NSS/Scouts Guide

DECLARATION/UNDERTAKING FROM THE STUDENT

I, Mr./Ms

Class: Section:


Phone No.(Whatsapp Number Compulsory):
Address(Permanent Home Address):,

Do hereby undertake the following

  1. I, hereby, declare that, the entries made by me in the Application Form are complete and true to the best of my knowledge and based on records.
  2. I hereby declare that I have read rules & eligibility criteria carefully from prospectus before applying to any course .Govt V.Y.T PG College Durg will not be responsible for errors made by me in such cases.
  3. I hereby declare that, I will opt for GEC, AEC, VAC, & SEC courses as required by the ordinance and offered by the college .
  4. I, hereby, promise to abide by the rules and regulations of admission, discipline, attendance, fee deposits and fee withdrawal of the Institute and also to follow the Code of Conduct prescribed for the students of the Institute (www.govtsciencecollegedurg.ac.in), as in force from time to time and subsequent changes / modifications / amendement made thereto. I acknowledge that, the Institute has the authority for taking punitive actions against me for violation and / or non-compliance of the same.
  5. I, hereby declare that, I will not indulge in, or tolerate ragging, in any form, even in words or intentions, and I accept to give an undertaking in the prescribed format for the same.
  6. I, further declare that, my admission may be cancelled, at any stage, if I am found ineligible and / or the information provided by me are found to be incorrect.

Date: *

Signature of Student:

Upload Student Photo*

DECLARATION / UNDERTAKING FROM THE PARENTS

I Mobile No ( Father / Mother/ Guardian) hereby fully endorse the above undertaking / declaration given by my child / ward. And I will endeavour to induce my child / ward to do his / her best to observe the above stated undertaking in words & spirit.

Place :

Signature of Father / Mother / Local Guardian:

Date:

Documents to be Submitted along with the hard copy of a filled in form













FOR OFFICE USE ONLY (College Copy)


SEMESTER SUBJECT
DSC
GEC
AEC
SEC
VAC

VERIFIED BY:

Signature Admission S/C Signature student Receipt No

APPROVED BY:

Signature of Principal :

VERIFICATION

Applicant is found eligible for admission on .

FOR OFFICE USE ONLY (Student Copy)


SEMESTER SUBJECT
DSC
GEC
AEC
SEC
VAC

VERIFIED BY:

Signature Admission S/C Signature student Receipt No

APPROVED BY:

Signature of Principal :

VERIFICATION

Applicant is found eligible for admission on .