Form

A

D.A.V. College, Chandigarh

Application Form for Admission

2014-2015

For Office Use Only

Sr. No. ..................................

Application Form

Received on..

Signature of Receiver ................

Class Section..Roll No.

Amount received RsReceipt No...Dated

CLASS/PROGRAMME YOU WISH TO JOIN: .......................

Result of Previous Year: Pass/Fail/Compartment:

Category/Categories against which application is being submitted (Put ;

mark in the relevant box):











Panjab University Registration Number (if any)
Panjab University PUPIN (11 digit identification Number, if any)

1.

Name of the applicant (in block letters): (as in tenth class certificate) (Leave one blank space between parts of Name)


2.

(a) Fathers Name

(in block letters)

(As in tenth class certificate)


Occupation : ____________________________ Position/Designation _____________________ Office Address__________________________
_______________________________________Phone No.______________________________ Mobile No. ____________________________ __
(b) Mothers Name

(in block letters) (As in tenth class certificate)


Occupation : ____________________________ Position/Designation _____________________ Office Address__________________________
_______________________________________Phone No.______________________________ Mobile No. ____________________________
(c) Guardians Name

(if applicable):


Occupation : ____________________________ Position/Designation _____________________ Office Address__________________________

_______________________________________Phone No.______________________________ Mobile No. ____________________________

3.

Annual income from all sources Rs.

(For availing half fee concession admissible to students whose parents' income is not more than Rs. 1,00,000 p.a. attach documentary proof.)

4.

Date of Birth:

5.(a) Sex(M/F)

5.(b) Blood Group

6.

Birth Particulars : (i) Place __________________________________ (ii) District_______________________________________________


(iii) State__________________________________ (iv) NATIONALITY _________________________________________

7.

Full address for correspondence: ____________________________________________________________________________________

___________________________________________________________________________________Mobile No.___________________

Telephone No. _______________________ Pin Code: _________________E-mail Address ______________________________________

8.

Permanent Home Address: _________________________________________________________________________________________

___________________________________________________________________________________Mobile No.___________________

Telephone No. ______________________ Pin Code: _________________E-mail Address _______________________________________

(Attach photo copy of Residence Proof)

9.

Subjects/options you want to study (Please refer to Prospectus.)

(i) _______________________ (ii) ___________________________(iii) ________________________ (iv)__________________________

(v) ______________________

(vi) __________________________ (vii) _______________________ (viii) _________________________

(ix) _____________________(x) __________________________

9.(a)*Please write optional subject:

(For B.Com. IIIrd year)


(1. Operational Research

(OR)

or

2. Organisational Behaviour)

(OB)

:______________________________________________________

9.(b)*For all students of Ist year: Please fill as per eligibility (see prospectus)

(1. HCP or 2. Punjabi) : ___________________________________________________________________________________________


* 9.(a) & 9.(b) are mandatory

General

Scheduled Caste

Sports Persons

*Physically Handi-
capped/VH/blind


Widows/Divorced
Women



Defence Personnel quota

Terrorist Victims

Freedom Fighters

Kashmiri Migrants

FOREIGN NATIONAL

NRI

Industry Sponsored

Single Girl Child


For admission to M.Sc.-I in

Phy/Chem/Zoo/Bioinfo/Biotech/MBE

Whether appeared in O-CET conducted

by P.U. ; the right box

Yes

No



Roll No. __________________

50% of the marks obt. in O-CET ___________________________

50% of the marks obt. in B.Sc./BA/B.Com___________________


PASTE YOUR
PHOTO HERE
DO NOT

STAPLE

U.T. Pool

General Pool

Are you

claiming

any weightage : Yes/No



7. (a) Applicant's Mobile Number _______________________________________________________________________________________
10.

Previous class details:

Session _______________Class ______________Roll No.______________

(For old students of the College)

.......
If Yes, marks obtained _____________ Rank ________________

11.

Subjects of Hons, you wish to opt for

(for B.A. / B.Com. students) ___________________________

(Students are required to fill up the attached form for Hons subjects)

12.

Have you passed in English in class XII exams? Yes/No.

13.

Mention gap

years, if any. (Furnish affidavit explaining gap) ___________________________________________________________

14.

Have you ever been punished for misbehaviour or for using unfair means? If Yes, give details. ________________________________

_______________________________________________________________________________________________________

15.

Have you ever been disqualified by any Board / University? If Yes, give details. ___________________________________________

_______________________________________________________________________________________________________

(No candidate is admitted under any circumstances during disqualification period)

16.

Are you migrating from another college / University? If Yes, give details. _________________________ _______________________


__________________________________________Migration Certificate attached? Yes/No

17.

Do you suffer from any serious ailment? If so give details including details of treatment. ____________________________________

_______________________________________________________________________________________________________________

18.

For Foreign Students Only (Attach photostat copy of passport, duly attested and Eligibility Certificate from Panjab Universit y)


(a)

Nationality _______________________________________ (b) Passport No. ____________________________________________



19.

Compartment in the subject of _______________________________________________________


DECLARATION BY THE APPLICANT

AND THE PARENTS/GUARDIAN


1.

I declare that I have carefully read the instructions and state that the entries made by me in this form are correct to the b est of my
knowledge and nothing has been concealed. I understand that my admission is liable to be cancelled if any of the statements

made by
me is found incorrect.

2.

I undertake to observe proper standards of academic conduct and not to associate with any activity that goes against the

discipline of
the College.

3.

I shall abide by the rules and regulations of the College and the Panjab University.

4.

I shall faithfully carry out the instructions issued by the College authorities from time to time.

5.

I hold myself responsible for due and prompt payment of fees and all other dues.

6. I understand that I cannot concurrently be enrolled for more than one full -time course of studies.
7.

I am fully aware that ragging, smoking and drinking liquor is strictly prohibited in the College/Hostel. If I am found guilty

of

indulging in
these activities, I shall

be liable for punishment and expulsion from the Hostel/College.

8.

I solemnly state that I am not facing any disciplinary proceedings and have not been disqualified by any Board/University.

9.

I have not so far been admitted to any affiliated College/Dept. of the Panjab University in the class to which I am seeking

admission.

10.

I shall not smoke and drink in and around the College.

11.

I shall not use mobile phone in the College.

12.

I shall fulfil the requirements of the Panjab University i.e. is 75% attendance of the lectures and 25% marks in House tests.

14.

I solemnly declare that the certificates submitted by me along with this application are true and have not been tampered with
. I

understand that my admission is liable to be cancelled if any
of the certificates is found to be false.


...............................................................

Date..................................

(Full Signature of the Candidate)


I certify that my son/daughter/ward is making this application with my permission. I hold myself responsible for his/her good conduct

and
behaviour as a student of the College and for payment all his/her dues during his/her stay in the College. I undertake respon sibility

that my
son/daughter/ward will attend the classes regularly and punctually to complete the required percentage of attendance as per

the Panjab
University rules, failing which I understand that he/she will be rendered ineligible for the final examinations.


Date ...................................

.............................................................

(Full Signature of the Parent/Guardian)

Name...........................................................................

Address........................................................................

.....................................................................................

.....................................................................................




For B.A.

Subject combination

No. as given in the college
prospectus on

page no. 15

Note:

1. Applicant is require to fill Form A and Form C (for new student) and Form A, Form B and Form C (for old student)

2. Incomplete application or with wrong/deliberately concealed information is liable to be straightaway rejected.

I have not been involved in any criminal activity and have never been convicted under any criminal offence. I also state that no FIR is registered
against me or any criminal proceedings are still pending against me at the time of submission of application. Further, I will not possess/carry
any weapon on the College Campus and if any weapon is recovered from me, I understand that I can be resticated for such an offence.
13.
INSTRUCTIONS FOR CANDIDATES


1.

This form must be filled by the candidate in his or her own hand in a clear and legible manner.

2.

This application form complete in all respects must be submitted to the College office as has been indicated in the Admission

Notice
as

well as in the Prospectus on or before the last date

indicated, even if the result of the qualifying examination has not

been
declared.

3.

The application form must be completed in all respects. No column should be left unfilled. If any Information sought is not

applicable
to the candidate the word "NA" should be entered against this column. If a candidate omits/conceals relevant

information or gives
false information, his/her admission is liable to be cancelled.

4.

Attested copies of Board/University Certificates, Certificates claiming special status, etc . must be attached to this application

form.
In case the required documents are not attached, the application is liable to be rejected as incomplete.

5.

The declaration to be made by the candidate and his/her parent on page 3 should be signed and dated before the application is

submitted.

6.

All certificates/documents submitted by the candidate with this form must be signed by the candidate himself/herself also.


Note:

THE CANDIDATES SHOULD UNDERSTAND THAT THE ADMISSION IF GRANTED BY THE COLLEGE WOULD BE

PROVISIONAL AND
SUBJECT TO CONFIRMATION BY THE UNIVERSITY.


DOCUMENTS TO BE SUBMITTED WITH APPLICATION FORM


Submit the following documents and put

;

in the box.


1.

Attested copies of Board or University Certificates showing the date of birth and detai ls of previous examinations

passed
and detailed marks certificates. (Original Detailed Marks Certificate issued by the University or the Board should

be
produced at the time of interview.)

2.

An attested copy of the certificate of good conduct from the Head of the Institution last attended.

3.

Three copies of recent passport size photograph. (One pasted, two stapled).

4.

The students will have to submit a personal affidavit about their marks to the college in case their result gazettes are not
available with the college.

5.

Original Migration Certificates in case of candidates seeking admission to the college from
Universities/Boards/Councils/Bodies other than Panjab University. Migration Certificate can be submitted latest before
20
th

September, 20141

because it must reach the Panjab University Office by 30
th

September, 2014 Candidate seeking
admission to Diploma/Certificate

courses will submit No Objection Certificate from the parent University/Institution in
place of Migration Certificate.

6.

Certificates relevant to claim any reserved category status.

7.

Affidavit explaining gap year/years, if any.

8.

Certificates in support of claim for weightage/weightages.

9.

Eligibility certificate.

10.

Foreign students are admitted if they have eli gibility certificate from Panjab University and a long term visa.

11.

An attested photo copy of residence proof/Aadhar Card/Voter Card/Passport etc.

12.

Any Other ____________________________________________________________


TOTAL NUMBER OF DOCUMENTS SUBMITTED _________________________________


7. Information on courses attended / admission taken by the applicant in preceding 3 years must be filled by him/her in the academic
record.
ACADEMIC RECORD


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Examination Name of
university/
Board and
Roll No.
Subjects


Matric / Class X



XIIth Class Exam,
under 10+2 or

its equivalent



B.A./B.Sc./B.Com./
BBA/BCA Part-I


B.A./B.Sc./B.Com./

BBA/BCA Part-II

B.A./B.Sc./B.Com./

BBA/BCA Part-III

B.A. (Hons.)

B.Sc. (Hons.)

B.Sc. (Hons. School)

B.Com. (Hons.)


M.Com/MBE 1
st

Sem.


2
nd

Sem.


3
rd

Sem.





Any other Exam.
Signatures of the Applicant
Admission Remarks
Percentage in the previous exam :
Deficient in the subject of :
Documents required :




Prof. in-charge Dean Admission

Principal

M.A./M.Sc 1
st
Sem
2
nd
Sem
3
rd
Sem