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Admission

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GOBINDGARH PUBLIC COLLEGE,ALOUR (KHANNA)
APPLICATION FORM FOR ADMISSION
SESSION 2017-18

All * Mark Fields are Compulsary

Session*:
Class*:
Full Name*:
Select Gender*:
MaleFemale
Father's Name*:
Mother's Name*:
Date of Birth*:

Age in Year & Month*:
Registration No of P.U Chandigarh (if Any):
Gardian's Name & Relation(if father is deceased)*:
Relation with Guardian*:
Father's / Guardian's Occupation*:
Designation*:
Permanent Address*:
Email:
Father Mobile Number*:
Correspondence Address*:
Valid Email ID*
Residence/Mother Mobile Number*:
Subjects To be Offered:







Academic Records

Metric Details

Month & Year of Passing*:
University/Board*:
Board Roll Number*:
Marks Obtained*:
Maximum Marks*:
Division*:
Percentage*:
School/College*:
Subjects Offered*:

Sr. Sec / +2 or equivalent Details

Month & Year of Passing*:
University/Board*:
Board Roll Number*:
Marks Obtained*:
Maximum Marks*:
Division*:
Percentage*:
School/College*:
Subjects Offered*:

BCA-I/ BA-I/ BA-I/ B. Com-I

Month & Year of Passing:
University/Board:
Board Roll Number:
Marks Obtained:
Maximum Marks:
Division:
Percentage:
School/College:
Subjects Offered:

BCA-II/ BA-II/ BA-II/ B. Com-II

Month & Year of Passing:
University/Board:
Board Roll Number:
Marks Obtained:
Maximum Marks:
Division:
Percentage:
School/College:
Subjects Offered:

BCA-III/ BA-III/ BA-III/ B. Com-III

Month & Year of Passing:
University/Board:
Board Roll Number:
Marks Obtained:
Maximum Marks:
Division:
Percentage:
School/College:
Subjects Offered:

Any Other

Month & Year of Passing:
University/Board:
Board Roll Number:
Marks Obtained:
Maximum Marks:
Division:
Percentage:
School/College:
Subjects Offered:

ADDITIONAL INFORMATION

Participation in Sports : Game/NCC/NSS:
Participation in Sports in 10+2 only:


Participation in Co-Curricular Activities:

Have you ever been punished for misconduct of for unfair means?
YesNo
Do you belong to SC/BC./P.H./Single girl child (no male Sibling):

Whether you belong to minority?
YesNo
Will you bring Cycle/Scooter/Car? If so, give its number:
What do you wish to become?*:
Will you avail bus facility?
YesNo
House:

FOR COLLEGE STUDENTS

Previous Class:
Class Roll No:
Session:

In case of late Declaration of Result

Name of the Exam Passed:
Date of Declaration:
Date of Form Submission*:



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