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PERSONAL DETAILS
thName of Applicant (exactly as it appears on 12 class mark sheet)
Mother's Name:
Father's Name:
Local Guardian's Name:
Date of Birth: Gender: (Please Tick 4 )
Date Month Year Male Female
Category: GEN SC ST OBC SBC Minority Others ___________
Physically Handicapped: Yes No Type of disability __________________ % of disability _____
Nationality: Indian Others If others, specify ___________________________________________
How did you hear about SMPGC ?
Newspaper Magazine Radio Internet Friends
Wall Painting Hoarding/Billboard Pamphlets Others___________________________
Applicant's PAN Parent's PAN
Form No. DownloadedAffix
Recent ColourPhotograph
CORRESPONDENCE ADDRESS (For all communication by the College)
Line 1___________________________________________________________________________________________________________
Line 2________________________________________________________________City/Town______________________________
State/Province _________________ Pin code______________Phone No. (With STD code)_______________________
(Applicant) Mobile No. ___________________________________ E-mail ___________________________________________
(Parent) Mobile No. ___________________________________ E-mail _______________________________________________
CONTACT DETAILS
ACADEMIC INFORMATION
Name of Examination
Board/University Name of the Institution
Year Subjects Division %
th 10
th12
U.G.
P.G.
Others
PERMANENT ADDRESS (If different from the Correspondence Address )
Line 1___________________________________________________________________________________________________________
Line 2________________________________________________________________City/Town______________________________
State/Province _________________ Pin code______________Phone No. (With STD code)_______________________
(Applicant) Mobile No. ___________________________________ E-mail ___________________________________________
(Parent) Mobile No. ___________________________________ E-mail _______________________________________________
HOSTEL FACILITY REQUIRED
VEHICLE PARKING REQUIRED If Yes, then Vehicle No ______________________
BANK LOAN REQUIRED
OTHER INFORMATION (This information is required for database purposes only and will not have any impact on the Admission process)
Name Qualification OccupationHome Phone /
Mobile No.E-mail Address
FamilyDetails
Father
Mother
Guardian
Yes
Yes
Yes
No
No
No
Course Applied for ______________________________________________________________________________________________
Subjects Chosen
1. 2. 3. 4.
5. 6. 7. 8.
• Are you interested in CPT / CS / ICWA (Foundation) Course Coaching
(Only for B.Com & BBA students) : If Yes, please specify________________________
st nd• Are you interested in IAS / RAS / SSC / Bank / Railway / LIC / 1 Grade / 2 Grade Teacher’s
Exam Coaching : If Yes, please specify________________________
Yes
Yes
No
No
CHECKLIST OF ENCLOSURES
S.No. Description Tick (4) if submitted
1. Four Passport Size Recent Color Photographs
2. Marksheets of Secondary, Senior Secondary & Last examination (Attested Photocopy)
3.
4.
5.
6.
7.
Migration Certificate (Attested Photocopy)
Transfer Certificate (Original)
Character Certificate from the Institute last attended (Original)
Bona fide Certificate (If Belonging to Rural Areas)
Caste Certificate (If any)
Physically Handicapped Certificate (If Applicable)
Other Achievements - Academic/N.S.S/N.C.C/Scout/Sports etc. (Attested Photocopy)
8.
9.
Eligible for Admission to_______________________________Application form checked by_________________________
Admission Fee ( I Installment) Receipt No.____________________Date__________________Rs.______________________
Admission Fee ( II Installment) Receipt No.___________________Date__________________Rs.______________________
Scholarship/Concession (If Applicable) Rs. ____________________________ Criteria______________________________
FOR OFFICE USE ONLY
TERMS AND CONDITIONS FOR ADMISSION
1. Non-refund of fee: All fee once deposited will not be refunded under any circumstances. Only
the Caution Deposit will be refunded after making necessary deductions as required.
2. Cancellation of Admission: The college reserves its right to cancel the admission of a
successful candidate under any of the following circumstances:
(a) If the fee is not deposited by the stipulated date.
(b) If the candidate does not join the particular course by the stipulated date even though
the fee has been deposited.
(c) If the candidate fails to furnish the proof of the stipulated minimum qualifications.
(d) If any of the document(s) submitted by the candidate to the college is found to be
forged, fabricated or false, during the period of study.
(e) If the attendance is not as per the required norms, the admission may be cancelled
immediately and the fee shall be forfeited.
(f) If the candidate is found to have violated the rules & regulations of the college , in any
way or manner.
3. Right of Alteration/Modification:
(a) The college reserves its right to change the Fee Structure.
(b) The college reserves its right to modify, alter and/or include any other terms and
conditions that may be deemed fit in the interest of the college and/or the students.
4. Jurisdiction: Any dispute pertaining to admission, or any matter as a student or alumnus of
the college shall be subject to the final arbitrary authority which rests with the college. Any
dispute will be subject to the jurisdiction of Jaipur court.
5. Limitation Clause: No dispute shall be recognized or entertained if raised after the expiry of
30 days of its occurrence.
Note: Only those students who belong to areas covered under Municipal Corporation / Municipal Council /
Municipal Board / Municipal Committee of Rajasthan shall be treated as belonging to urban areas, whilst
Name in Full: __________________________________________Date of Birth_______________________
Father's Name:______________________________________________________________________________
Mother's Name : ____________________________________________________________________________
Course _________________________________________________________ Year (I/II/III/Prev./Final) _______________________
Contact Address : ___________________________________________________________________________________________________
_____________________________________________________Pin Code______________________Tel. No.__________________________
Mobile No. (Self) : ________________________________ Mobile No. (Parent/Guardian) :_____________________________
Blood Group_______________________________________Aadhar Card No. : ____________________________________________
Student's Signature Principal's Signature
STUDENT IDENTITY CARD FORMSession (20_____- _____)
(To be filled in capital letters only)
AffixRecent Colour
Photograph
STUDENT IDENTITY CARD FORMSession (20_____- _____)
(To be filled in capital letters only)
AffixRecent Colour
Photograph
Name in Full: __________________________________________Date of Birth_______________________
Father's Name:______________________________________________________________________________
Mother's Name : ____________________________________________________________________________
Course _________________________________________________________ Year (I/II/III/Prev./Final) _______________________
Contact Address : ___________________________________________________________________________________________________
_____________________________________________________Pin Code______________________Tel. No.__________________________
Mobile No. (Self) : ________________________________ Mobile No. (Parent/Guardian) :_____________________________
Blood Group_______________________________________Aadhar Card No. : ____________________________________________
Student's Signature Principal's Signature
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