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Miss
Mrs
छात्रा का नाम (हिन्दी में) *
सुश्री
श्रीमती
लिंग (Gender)
महिला (Female)
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पिता/पति का नाम श्री *
माता का नाम श्रीमती *
छात्रा की जन्मतिथि *
राष्ट्रीयता*
-----राष्ट्रीयता का चयन करे -----
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American
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-----मातृ भाषा का चयन करे-----
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Khasi
Mundari
Ho
Other
धर्म *
----- धर्म का चयन करे -----
Hindu
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CHRISTHAN
OSWAL/JAIN
JAIN
MATHUR
Christian
Shikh
जाति *
संवर्ग जाति प्रमाण पत्र सलंग्न करें *
--------------चयन करे--------------
GEN
OBC
SC
ST
अल्पसंखयक
Yes
No
छात्रा का वर्तमान पता *
देश*
--------------चयन करे--------------
Afghanistan
Albania
ALGERIA
America
AMERICAN SAMOA
ANDORRA
ANGOLA
ANGUILLA
ANTARCTICA
ANTIGUA AND BARBUDA
ARGENTINA
ARMENIA
ARUBA
AUSTRALIA
AUSTRIA
AZERBAIJAN
BAHAMAS
BAHRAIN
BANGLADESH
BARBADOS
BELARUS
BELGIUM
BELIZE
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BERMUDA
BHUTAN
BOLIVIA
BOSNIA AND HERZEGOVINA
BOTSWANA
BOUVET ISLAND
BRAZIL
BRITISH INDIAN OCEAN TERRITORY
BRUNEI DARUSSALAM
BULGARIA
BURKINA FASO
BURUNDI
CAMBODIA
CAMEROON
CANADA
CAPE VERDE
CAYMAN ISLANDS
CENTRAL AFRICAN REPUBLIC
CHAD
CHILE
CHINA
CHRISTMAS ISLAND
COCOS (KEELING) ISLANDS
COLOMBIA
COMOROS
CONGO
CONGO, THE DEMOCRATIC REPUBLIC OF THE
COOK ISLANDS
COSTA RICA
COTE D IVOIRE
CROATIA
CUBA
CYPRUS
CZECH REPUBLIC
DENMARK
DJIBOUTI
DOMINICA
DOMINICAN REPUBLIC
EAST TIMOR
ECUADOR
EGYPT
EL SALVADOR
EQUATORIAL GUINEA
ERITREA
ESTONIA
ETHIOPIA
FALKLAND ISLANDS (MALVINAS)
FAROE ISLANDS
FIJI
FINLAND
FRANCE
FRENCH GUIANA
FRENCH POLYNESIA
FRENCH SOUTHERN TERRITORIES
GABON
GAMBIA
GEORGIA
GERMANY
GHANA
GIBRALTAR
GREECE
GREENLAND
GRENADA
GUADELOUPE
GUAM
GUATEMALA
GUINEA
GUINEA-BISSAU
GUYANA
HAITI
HEARD ISLAND AND MCDONALD ISLANDS
HOLY SEE (VATICAN CITY STATE)
HONDURAS
HONG KONG
HUNGARY
ICELAND
INDIA
INDONESIA
IRAN, ISLAMIC REPUBLIC OF
IRAQ
IRELAND
ISRAEL
ITALY
JAMAICA
JAPAN
JORDAN
KAZAKSTAN
KENYA
KIRIBATI
KOREA DEMOCRATIC PEOPLES REPUBLIC OF
KOREA REPUBLIC OF
KUWAIT
KYRGYZSTAN
LAO PEOPLES DEMOCRATIC REPUBLIC
LATVIA
LEBANON
LESOTHO
LIBERIA
LIBYAN ARAB JAMAHIRIYA
LIECHTENSTEIN
LITHUANIA
LUXEMBOURG
MACAU
MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF
MADAGASCAR
MALAWI
MALAYSIA
MALDIVES
MALI
MALTA
MARSHALL ISLANDS
MARTINIQUE
MAURITANIA
MAURITIUS
MAYOTTE
MEXICO
MICRONESIA, FEDERATED STATES OF
MOLDOVA, REPUBLIC OF
MONACO
MONGOLIA
MONTSERRAT
MOROCCO
MOZAMBIQUE
MYANMAR
NAMIBIA
NAURU
NEPAL
NETHERLANDS
NETHERLANDS ANTILLES
NEW CALEDONIA
NEW ZEALAND
NICARAGUA
NIGER
NIGERIA
NIUE
NORFOLK ISLAND
NORTHERN MARIANA ISLANDS
NORWAY
OMAN
PAKISTAN
PALAU
PALESTINIAN TERRITORY, OCCUPIED
PANAMA
PAPUA NEW GUINEA
PARAGUAY
PERU
PHILIPPINES
PITCAIRN
POLAND
PORTUGAL
PUERTO RICO
QATAR
REUNION
ROMANIA
RUSSIAN FEDERATION
RWANDA
SAINT HELENA
SAINT LUCIA
SAINT PIERRE AND MIQUELON
SAINT VINCENT AND THE GRENADINES
SAINTKITTS AND NEVIS
SAMOA
SAN MARINO
SAO TOME AND PRINCIPE
SAUDI ARABIA
SENEGAL
SEYCHELLES
SIERRA LEONE
SINGAPORE
SLOVAKIA
SLOVENIA
SOLOMON ISLANDS
SOMALIA
SOUTH AFRICA
SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS
SPAIN
SRI LANKA
SUDAN
SURINAME
SVALBARD AND JAN MAYEN
SWAZILAND
SWEDEN
SWITZERLAND
SYRIAN ARAB REPUBLIC
TAIWAN, PROVINCE OF CHINA
TAJIKISTAN
TANZANIA, UNITED REPUBLIC OF
THAILAND
TOGO
TOKELAU
TONGA
TRINIDAD AND TOBAGO
TUNISIA
TURKEY
TURKMENISTAN
TURKS AND CAICOS ISLANDS
TUVALU
UGANDA
UKRAINE
UNITED ARAB EMIRATES
UNITED KINGDOM
UNITED STATES
UNITED STATES MINOR OUTLYING ISLANDS
URUGUAY
UZBEKISTAN
VANUATU
VENEZUELA
VIET NAM
VIRGIN ISLANDS, BRITISH
VIRGIN ISLANDS, U.S.
WALLIS AND FUTUNA
WESTERN SAHARA
YEMEN
YUGOSLAVIA
ZAMBIA
ZIMBABWE
राज्य *
--------------चयन करे--------------
शहर *
--------------चयन करे--------------
पिन कोड
टेलिफोन नं.
मोबाईल *
ईमैल आइडी *
ब्लड् ग्रुप
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स्थायी पता (कन्सेशन के लिये यही पता मान्य होगा) *
देश *
--------------चयन करे--------------
Afghanistan
Albania
ALGERIA
America
AMERICAN SAMOA
ANDORRA
ANGOLA
ANGUILLA
ANTARCTICA
ANTIGUA AND BARBUDA
ARGENTINA
ARMENIA
ARUBA
AUSTRALIA
AUSTRIA
AZERBAIJAN
BAHAMAS
BAHRAIN
BANGLADESH
BARBADOS
BELARUS
BELGIUM
BELIZE
BENIN
BERMUDA
BHUTAN
BOLIVIA
BOSNIA AND HERZEGOVINA
BOTSWANA
BOUVET ISLAND
BRAZIL
BRITISH INDIAN OCEAN TERRITORY
BRUNEI DARUSSALAM
BULGARIA
BURKINA FASO
BURUNDI
CAMBODIA
CAMEROON
CANADA
CAPE VERDE
CAYMAN ISLANDS
CENTRAL AFRICAN REPUBLIC
CHAD
CHILE
CHINA
CHRISTMAS ISLAND
COCOS (KEELING) ISLANDS
COLOMBIA
COMOROS
CONGO
CONGO, THE DEMOCRATIC REPUBLIC OF THE
COOK ISLANDS
COSTA RICA
COTE D IVOIRE
CROATIA
CUBA
CYPRUS
CZECH REPUBLIC
DENMARK
DJIBOUTI
DOMINICA
DOMINICAN REPUBLIC
EAST TIMOR
ECUADOR
EGYPT
EL SALVADOR
EQUATORIAL GUINEA
ERITREA
ESTONIA
ETHIOPIA
FALKLAND ISLANDS (MALVINAS)
FAROE ISLANDS
FIJI
FINLAND
FRANCE
FRENCH GUIANA
FRENCH POLYNESIA
FRENCH SOUTHERN TERRITORIES
GABON
GAMBIA
GEORGIA
GERMANY
GHANA
GIBRALTAR
GREECE
GREENLAND
GRENADA
GUADELOUPE
GUAM
GUATEMALA
GUINEA
GUINEA-BISSAU
GUYANA
HAITI
HEARD ISLAND AND MCDONALD ISLANDS
HOLY SEE (VATICAN CITY STATE)
HONDURAS
HONG KONG
HUNGARY
ICELAND
INDIA
INDONESIA
IRAN, ISLAMIC REPUBLIC OF
IRAQ
IRELAND
ISRAEL
ITALY
JAMAICA
JAPAN
JORDAN
KAZAKSTAN
KENYA
KIRIBATI
KOREA DEMOCRATIC PEOPLES REPUBLIC OF
KOREA REPUBLIC OF
KUWAIT
KYRGYZSTAN
LAO PEOPLES DEMOCRATIC REPUBLIC
LATVIA
LEBANON
LESOTHO
LIBERIA
LIBYAN ARAB JAMAHIRIYA
LIECHTENSTEIN
LITHUANIA
LUXEMBOURG
MACAU
MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF
MADAGASCAR
MALAWI
MALAYSIA
MALDIVES
MALI
MALTA
MARSHALL ISLANDS
MARTINIQUE
MAURITANIA
MAURITIUS
MAYOTTE
MEXICO
MICRONESIA, FEDERATED STATES OF
MOLDOVA, REPUBLIC OF
MONACO
MONGOLIA
MONTSERRAT
MOROCCO
MOZAMBIQUE
MYANMAR
NAMIBIA
NAURU
NEPAL
NETHERLANDS
NETHERLANDS ANTILLES
NEW CALEDONIA
NEW ZEALAND
NICARAGUA
NIGER
NIGERIA
NIUE
NORFOLK ISLAND
NORTHERN MARIANA ISLANDS
NORWAY
OMAN
PAKISTAN
PALAU
PALESTINIAN TERRITORY, OCCUPIED
PANAMA
PAPUA NEW GUINEA
PARAGUAY
PERU
PHILIPPINES
PITCAIRN
POLAND
PORTUGAL
PUERTO RICO
QATAR
REUNION
ROMANIA
RUSSIAN FEDERATION
RWANDA
SAINT HELENA
SAINT LUCIA
SAINT PIERRE AND MIQUELON
SAINT VINCENT AND THE GRENADINES
SAINTKITTS AND NEVIS
SAMOA
SAN MARINO
SAO TOME AND PRINCIPE
SAUDI ARABIA
SENEGAL
SEYCHELLES
SIERRA LEONE
SINGAPORE
SLOVAKIA
SLOVENIA
SOLOMON ISLANDS
SOMALIA
SOUTH AFRICA
SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS
SPAIN
SRI LANKA
SUDAN
SURINAME
SVALBARD AND JAN MAYEN
SWAZILAND
SWEDEN
SWITZERLAND
SYRIAN ARAB REPUBLIC
TAIWAN, PROVINCE OF CHINA
TAJIKISTAN
TANZANIA, UNITED REPUBLIC OF
THAILAND
TOGO
TOKELAU
TONGA
TRINIDAD AND TOBAGO
TUNISIA
TURKEY
TURKMENISTAN
TURKS AND CAICOS ISLANDS
TUVALU
UGANDA
UKRAINE
UNITED ARAB EMIRATES
UNITED KINGDOM
UNITED STATES
UNITED STATES MINOR OUTLYING ISLANDS
URUGUAY
UZBEKISTAN
VANUATU
VENEZUELA
VIET NAM
VIRGIN ISLANDS, BRITISH
VIRGIN ISLANDS, U.S.
WALLIS AND FUTUNA
WESTERN SAHARA
YEMEN
YUGOSLAVIA
ZAMBIA
ZIMBABWE
राज्य *
--------------चयन करे--------------
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U.P.
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West Bengal
शहर *
--------------चयन करे--------------
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Dadra & Nagar Haveli
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Dibang Valley
Dibrugarh
Dima Hasao
Dimapur
Dindigul
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Diu
Doda
Dumka
Dungarpur
Durg
East
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East District
East Garo Hills
East Godavari
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Ernakulam
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Faizabad
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The Dangs
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Washim
Wayanad
West
West Champaran
West District
West Garo Hills
West Godavari
West Kameng
West Khasi Hills
West Nimar
West Siang
West Singhbhum
West Tripura
Wokha
Y.S.R. (Cuddapah)
Yadgir
Yamunanagar
Yanam
Yavatmal
Zunheboto
पिन कोड
आपकी महत्वाकांक्षा
माध्यम *
------ माध्यम का चयन करे -------
Hindi
English
अनिवार्य विषय *
( इनमें से किसी एक का चयन करे )
ऐच्छिक विषय *
1. प्रत्येक समूह से केवल एक विषय चयन करते हुए तीन विषयों का चयन करें |
2. जय नारायण व्यास विश्वविद्यालय के निर्देशानुसार इस वर्ष छात्रा दो प्रैक्टिकल विषय उपरोक्त ग्रुप में सें चुनकर ले सकती है।
अन्तिम उत्तीर्ण परीक्षा *
Senior Secondary B.A. 1 YEAR B.A. 2 YEAR B.A. 3 YEAR B.Sc. 1 YEAR B.Sc. 2 YEAR B.Sc. 3 YEAR B.Com. 1 YEAR B.Com. 2 YEAR B.Com. 3 YEAR Secondary M.A. 1 YEAR M.COM. 1 YEAR M.SC. 1 YEAR B.B.A YEAR 2 B.C.A YEAR 2 B.B.A YEAR 1 B.C.A YEAR 1 B.Com.(Hon) Prev B.Com.(Hon) Final B.C.A. 3 YEAR B.B.A YEAR 3
संकाय *
---चयन करे---
Arts
Commerce
Science
बोर्ड अथवा युनिवर्सिटी का नाम *
उत्तीर्ण / अनुत्तीर्ण होने का वर्ष *
Student Subject Wise Exam * :
यदि किसी वैकल्पिक विषय में पूरक परीक्षा देनी है*
हाँ
नहीं
यदि हाँ तो उस विषय का नाम *
पिता का व्यवसाय*
Government
Private
Other
व्यवसाय का विवरण *
---- सरकारी विभाग का चयन करें ----
Administrative Reforms(AR)
Advocate General, Rajasthan(AGR)
Agriculture(AGRICULTUR)
Animal Husbandry(AH)
Anti Corruption Bureau(ACB)
Archaeology and Museums(AM)
Ayurved(AYURVED)
Biofuel(BIOFUEL)
Board of Revenue(BOR)
Board of Technical Education(BOTE)
Bureau of Public Enterprises(BPE)
Chief Minister Office(CMO)
Co-operative(CO)
College Education(CE)
Command Area Development and Water Utilization(CADWU)
Commercial Taxes(CT)
Disaster Management & Relief(DMR)
Economics & Statistics(ES)
Education(EDUCATION)
Election(ELECTION)
Employee State Insurance(ESI)
Employment(EMPLOYMENT)
Energy(ENERGY)
Environment(ENVIRONMEN)
Evaluation Organization(EO)
Excise(EXCISE)
Factories and Boilers Inspection(FBI)
Finance(FINANCE)
Food(FOOD)
Forest(FOREST)
General Administration & Cabinet Secretariat(GACS)
HCM Rajasthan State Institute of Public Administra(HRSIPA)
Home(HOME)
Horticulture(HORTICULTU)
Indira Gandhi Panchayati Raj & Gramin Vikas Sansta(IGPRGVS)
Industry(INDUSTRY)
Information & Public Relations(IPR)
Information Technology & Communication(ITC)
Jaipur Police(JP)
Justice(JUSTICE)
Labour(LABOUR)
Literacy & Continuing Education(LCE)
Medical Education(ME)
Medical health and family welfare(MHFW)
Mines & Geology, Rajasthan(MGR)
Minority Affairs(MA)
National Rural Health Mission(NRHM)
Panchayati Raj(PR)
Pension & Pensioners Welfare(PPW)
Personnel(PERSONNEL)
Petroleum(PERTOLEUM)
Planning(PLANNING)
Public Health Engineering(PHE)
Public Works(PW)
RajSWAN MIS Portal(RMISP)
Rajasthan Civil Services Appellate Tribunal(RCSAT)
Rajasthan Foundation(RF)
Rajasthan High Court(RHC)
Rajasthan Police(RP)
Rajasthan Police Academy(RPA)
Rajasthan Public Service Commission(RPSC)
Rajasthan Rural Livelihood Project(RRLP)
Rajasthan Tax Board, Ajmer(RTBA)
Rajasthan Urban Infrastructure Development Project(RUIDP)
Redressal of Public Grievances(RPG)
Registration & Stamps(RS)
Rural Development(RD)
Sanskrit Education(SE)
Science & Technology(ST)
Social Justice & Empowerment(SJE)
Soldier Welfare Department(SWD)
State Election Commission(SEC)
State Insurance & Provident Fund(SIPF)
Technical Education(TE)
Tourism(TOURISM)
Transport(TRANSPORT)
Treasuries and Accounts (DTA), Rajasthan(TAR)
Tribal Area Development(TAD)
Urban Development & Housing(UDH)
Water Resources(WR)
Watershed Development & Soil Conservation(WDSC)
Women and Child Development(WCD)
Indian Railway(IR)
MSME Development Institute, Jaipur(MSMEDIJ)
National Informatics Centre, Rajasthan(NICR)
Office of The Registrar General and Census Commiss(OTRGCC)
Rajasthan Telecom Circle(RTC)
Other(Other)
पिता का शैक्षणिक स्तर *
---- शैक्षणिक स्तर ----
Primary
Secondary (10)
Senior Secondary (10+2)
Graduate (UG)
Post Graduate (PG)
Diploma
Illiterate
माता का व्यवसाय *
Government
Private
Other
व्यवसाय का विवरण *
---- सरकारी विभाग का चयन करें ----
Administrative Reforms(AR)
Advocate General, Rajasthan(AGR)
Agriculture(AGRICULTUR)
Animal Husbandry(AH)
Anti Corruption Bureau(ACB)
Archaeology and Museums(AM)
Ayurved(AYURVED)
Biofuel(BIOFUEL)
Board of Revenue(BOR)
Board of Technical Education(BOTE)
Bureau of Public Enterprises(BPE)
Chief Minister Office(CMO)
Co-operative(CO)
College Education(CE)
Command Area Development and Water Utilization(CADWU)
Commercial Taxes(CT)
Disaster Management & Relief(DMR)
Economics & Statistics(ES)
Education(EDUCATION)
Election(ELECTION)
Employee State Insurance(ESI)
Employment(EMPLOYMENT)
Energy(ENERGY)
Environment(ENVIRONMEN)
Evaluation Organization(EO)
Excise(EXCISE)
Factories and Boilers Inspection(FBI)
Finance(FINANCE)
Food(FOOD)
Forest(FOREST)
General Administration & Cabinet Secretariat(GACS)
HCM Rajasthan State Institute of Public Administra(HRSIPA)
Home(HOME)
Horticulture(HORTICULTU)
Indira Gandhi Panchayati Raj & Gramin Vikas Sansta(IGPRGVS)
Industry(INDUSTRY)
Information & Public Relations(IPR)
Information Technology & Communication(ITC)
Jaipur Police(JP)
Justice(JUSTICE)
Labour(LABOUR)
Literacy & Continuing Education(LCE)
Medical Education(ME)
Medical health and family welfare(MHFW)
Mines & Geology, Rajasthan(MGR)
Minority Affairs(MA)
National Rural Health Mission(NRHM)
Panchayati Raj(PR)
Pension & Pensioners Welfare(PPW)
Personnel(PERSONNEL)
Petroleum(PERTOLEUM)
Planning(PLANNING)
Public Health Engineering(PHE)
Public Works(PW)
RajSWAN MIS Portal(RMISP)
Rajasthan Civil Services Appellate Tribunal(RCSAT)
Rajasthan Foundation(RF)
Rajasthan High Court(RHC)
Rajasthan Police(RP)
Rajasthan Police Academy(RPA)
Rajasthan Public Service Commission(RPSC)
Rajasthan Rural Livelihood Project(RRLP)
Rajasthan Tax Board, Ajmer(RTBA)
Rajasthan Urban Infrastructure Development Project(RUIDP)
Redressal of Public Grievances(RPG)
Registration & Stamps(RS)
Rural Development(RD)
Sanskrit Education(SE)
Science & Technology(ST)
Social Justice & Empowerment(SJE)
Soldier Welfare Department(SWD)
State Election Commission(SEC)
State Insurance & Provident Fund(SIPF)
Technical Education(TE)
Tourism(TOURISM)
Transport(TRANSPORT)
Treasuries and Accounts (DTA), Rajasthan(TAR)
Tribal Area Development(TAD)
Urban Development & Housing(UDH)
Water Resources(WR)
Watershed Development & Soil Conservation(WDSC)
Women and Child Development(WCD)
Indian Railway(IR)
MSME Development Institute, Jaipur(MSMEDIJ)
National Informatics Centre, Rajasthan(NICR)
Office of The Registrar General and Census Commiss(OTRGCC)
Rajasthan Telecom Circle(RTC)
Other(Other)
माता का शैक्षणिक स्तर *
---- शैक्षणिक स्तर ----
Primary
Secondary (10)
Senior Secondary (10+2)
Graduate (UG)
Post Graduate (PG)
Diploma
Illiterate
पिता की आय (मासिक)*
माता की आय (मासिक)*
अन्य आय (मासिक)
परिवार में सदस्यों की संख्या *
स्थानीय संरक्षक का विवरण:
(अ) संरक्षक का नाम एवं सम्बन्ध
Copy Address To Guardian Address
(ब) संरक्षक का पता
(स) टेलीफोन नं.
आपातकालीन सूचना हेतु फोन नं *
बस सुविधा की जरूरत है या नहीं *
----- चयन करे -----
Yes
No
----- चयन करे -----
PAOTA
MANDORE
JALORI GATE
C.H.B.
RATANADA
MAHAMANDIR
KUDI BHAGTASANI HOUSING BOARD
अन्य गतिविधिया
Sports
NCC
NSS
शैक्षणिक उपलब्धियों का विवरण:
फोटो अपलोड *
(JPG,JPEG,GIF,PNG IMAGE WITH SIZE UPTO 50 KB)
हस्ताक्षर अपलोड *
(JPG,JPEG,GIF,PNG IMAGE WITH SIZE UPTO 50 KB)
Enter The Text Of Image *
निम्नलिखित प्रमाण-पत्रों सहित आवेदन-पत्र प्राप्त किया
1. अर्हकारी परीक्षा की मूल अंक तालिका तथा दो सत्यापित प्रतिलिपि
5. माइग्रेशन प्रमाण-पत्र मूल एवं दो प्रतिलिपि
2. माध्यमिक परीक्षा के प्रमाण पत्र की दो प्रतिलिपि
6. गत संस्थान द्वारा प्रदत्त चरित्र प्रमाण-पत्र की मूल प्रति
3. स्थानान्तरण प्रमाण-पत्र मूल एवं दो प्रतिलिपि
7. आय प्रमाण-पत्र की दो प्रतिलिपि
4. अ.जा. / अ.जा.जाति/ अ.पि.वर्ग / विकलांग प्रमाण-पत्र की दो प्रतिलिपि कश्मीरी वि. प्रमाण-पत्र
8. खेलकूद एन.सी.सी. एन.एस.एस. प्रमाण-पत्र
9. अन्य
नोट:
1. सभी प्रमाण-पत्रों की प्रतियां सत्यापित होनी चाहिए एवं विद्यार्थी महाविद्यालय में आवश्यक प्रमाण-पत्र जमा करवाने के पश्चात ही प्रवेश के लिए योग्य होगा।
2. महाविद्यालय परिसर में मोबाइल लाना मना है| छात्रा के पास मोबाइल पाये जाने पर दण्डात्मक कारवाई की जाएगी |
3. महाविद्यालय में यूनिफार्म में आना अनिवार्य है |
घोषणा
मैं महाविद्यालय के अनुशासन तथा अन्य समस्त नियमों का भली-भांति पालन करूंगी , एव में किसी भी प्रकार की रेगींग और किसी को भी उत्पीड़ित करने के मामले में समलित नहीं रहूंगी | मैंने प्रवेश नियम एवं सामान्य अनुदेश सूचना पुस्तिका से पढ लिए हैं और सब नियम मुझे स्वीकार है। मैं यह घोषणा करती हूँ कि मैं किसी सरकारी / अर्धसरकारी या निजी संस्थान में कार्य नही करती हूँ ।
दिनांक :
छात्रा के हस्ताक्षर
मैं प्रमाणित करता हूं कि उपरोक्त विवरण ठीक है और मैं उसका पिता संरक्षक होने के नाते उसके आचरण तथा वित्तीय संबंधी उत्तरदायित्व के लिए उत्तरदायी रहूंगा। छात्रा की नियमित उपस्थिति (न्यूनतम 75 प्रतिशत) सुनिश्चित करूंगा अन्यथा परीक्षा में प्रवेश से वंचित होने की दशा में स्वयं उत्तरदायी रहूंगा।
दिनांक :
पिता / संरक्षक के हस्ताक्षर