Application form for admission to Post-Graduate Degree Course

 App. No 1544983289
N.B. 1) Fill all the columns carefully. Incomplete form will not be accepted.
2) Wrong / False information, If provided, will lead to cancellation of admission.
Admission sought in year of M.Sc. (Physics) during the academic year 2018 -19
1. Name : Mr./Ms ((IN BLOCK LETTERS) (As appeared in HSC Certificate)
Surname

Name

Fathers name

Mothers name

2. Present Address

3. Native Place Address: (for long journey concession)

Student Contact No.

Parent Contact No.

4.Email id 5.Date of Birth 6.Place of Birth
7.State 8.District 9.Caste
10.Religion 11.Mother Tongue 12.Adhar Card No
13.Do you belong to SC/ST/DT/NT/VJ NT/ OBC/ SBC (If Yes, submit documentary proof for the same for getting freeship/scholarship)
14.Do you belong to Muslim / Sikh / Boudh/ Christian/ Parsi/ Jain/ Maratha Community?

15. Academic Record (Attach Xerox copies of Marksheet)

Examination Passed Board / University Month & Year Pass/ ATKT Class/ Grade Obtained
S.S.C
H.S.C
B.Sc.(Sem V & Sem VI)
*Excluding AC paper
M.Sc. (Part – I)
16. Particulars of Father / Guardian.

a. Name b. Relationship with the student (in case of guardian)
c. Occupation d. Office Phone No.
e. Office Address ;
DECLARATION BY THE APPLICANT

The Principal,
N.E.S. Ratnam College of Arts, Science & Commerce
Bhandup (West), Mumbai - 400078.
 
Madam,
I, seek admission in
class of your college with the consent of my Parent / Guardian Mr. /Mrs.
a. I undertake to abide by all the rules and regulations of the college, particularly those relating to to conduct and discipline, which are in force at present and which may be enforced in future.
b. I undertake that i will not damage or destroy the college property / mutilate or damage any book issued to me from the college library.
c. I understand that I shall not be granted by any term, if my attendance at lectures, tutorials and practicals fall short of the minimum prescribed by the university.
d. I shall not indulge in any kind of activities which will mar the academic atmosphere and prestige of the college.
e. I know smoking is strictly prohibited in the college premises including canteen.
f. I know that use of mobile phone in the college premise is punishable as per University guidelines.
g. I understand that violation of any Discipline Rule's Will result in removal of my name from the college record and I agree to it.
date Yours Faithfully

 

(Applicant’s Signature)

 

 

DECLARATION BY THE PARENT / GUARDIAN

 

1. I, on my part agree to the conditions / rules stated above.

2. I assure you that my ward Mr. / Ms. if admitted, will be regular in

    attendance of Lectures / Tutorials / Practicals / Test / Examinations.

3. In case the attendance / performance of my ward is / are not satisfactory, he / she may not be granted terms

    and he / she also not be sent for the College / University Exam.

4. I am aware that violation of any of the Discipline Rule/s by my ward will result in his / her removal from the

    college & I agree it.;

 

Date:

 

(Signature of Parent / Guardian)

FOR OFFICE USE ONLY

 

Document required to be attached.

 

Please Tick the documents received.

1. Original Marksheet of B.Sc. and 2 attested Xerox copies of the same.

2. Original N.O.C. / T. C. and 2 attested Xerox copies of the same.

3. 1 attested Xerox copy of marksheet of each of the lower Examinations – Sem I & II (for M.Sc. Part – II)

4. Caste certificate and 1 attested Xerox copy(only for students belonging to (SC/ST/DT/NT/VJNT/OBC/SBC)

5. Affidavit (where there is a break in studies)

6. Students passing the qualifying examination from University other than Mumbai University shall be required to attach the following additional certificates along with above mentioned certificates.

a. Original Migration Certificate and 2 attested Xerox copies.

b. Original Leaving Certificate and 2 attested Xerox copies.

 

(REMARKS OF THE ADMISSION COMMITTEE)

__________________________________________________________________________________________

 

___________________________________________________________________________________________

 

 

Date:

 

 

Signature of staff

Admission Committee