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S I K K I M
All entries must be filled by the candidate himself / herself in capital letters. Put for Yes and X for No and NA
where Not applicable in the box. The Application Form consists of two pages
Please enclose
four identical photographs
ENROLMENT No.
(Leave Blank)
YEAR OF
ENROLMENT
along with
COURSE
APPLIED FOR
YEAR OF STUDY
(1, 2, 3)
SESSION: JUNE
DECEMBER
NAME OF
CANDIDATE
FATHERS
NAME
Fathers
Occupation
MOTHERS
NAME
Mothers
Occupation
GENDER
Male
Female
Other
DATE OF BIRTH DD / MM / YY
PERMANENT
ADDRESS
MAILING
ADDRESS
PIN CODE
CITY
STATE
PH. No.
PIN CODE
CITY
STD CODE
MOB. No.
STATE
PH. No.
STD CODE
MOB. No.
E-MAIL
Any change in address should be immediately communicated to the University
NATIONALITY
CATEGORY
INDIAN
GENERAL
OTHERS
SC
ST
PH
EX-SERVICEMAN
NO
EMPLOYED
UNEMPLOYED
OTHERS
DETAILS OF PREVIOUS EXAMINATIONS PASSED FROM THE UNIVERSITY/BOARD (Enclose Duly Attested Photocopies of the Previous Mark Cards / Certificates)
S. NO.
ROLL NO.
YEAR/SEMESTER
PERCENTAGE SCORED
UNIVERSITY / BOARD
PASS / FAIL
FEE DETAILS
S. No.
PARTICULARS OF FEE
PAYMENT DETAIL
Course Fee
Examination Fee
Lateral Entry / Credit Transfer Fee
Other ________________________
TOTAL AMOUNT
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Contd.
INSTRUCTIONS
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Write clearly and legibly with NO OVERWRITIG / NO SCRIBLING / NO USE OF WHITE FLUIDS.
Photocopy of forms will not be accepted by the University.
Use Black/Blue Ball point pen only for filling up the application form.
Affix/Paste one recent passport size photograph on the application form. Attach three recent passport size photograph along with
the application form, use clip (do not staple/pin). Write you name and form no. behind the additional photo.
Kindly endorse on the backside of the Demad Draft - Name, Fathers/Gaurdians Name, Address & Phone No, Course and
Semester.
Admission Form found incomplete in any respect or sent without requisite fee will be summarily rejected after deducting Rs. 1000/
as a Processing Fee. Once the admissions is processed, there will be no refund of fee under any circumstances.
Applications received after the specified date will not be entertained. Late Fee will be charged, if any.
Suppression or furnishing of any false information by a candidate will lead to immediate cancellation of his/her admission with no
refund of fees.
All required documents to be furnished along with the Admission Form at the time of Registration, failing which your admission
shall be considered as provisional.
Candidate is advised to keep a photocopy of DD and Application Form with him/her.
SIGNATURE
AR/DR
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End