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Admission Form for Students

This admission form collects personal details, educational qualifications, and course preferences from applicants to Shambhunath Group of Institutions. It requests information such as name, date of birth, category, contact details, educational history, examination scores, preferred programs of study, and contains a declaration of truthfulness that is signed by both the applicant and parent/guardian. The form is used to process applications for undergraduate and postgraduate technical programs at the affiliated engineering, pharmacy, and management institutes.

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ManKap
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35 views4 pages

Admission Form for Students

This admission form collects personal details, educational qualifications, and course preferences from applicants to Shambhunath Group of Institutions. It requests information such as name, date of birth, category, contact details, educational history, examination scores, preferred programs of study, and contains a declaration of truthfulness that is signed by both the applicant and parent/guardian. The form is used to process applications for undergraduate and postgraduate technical programs at the affiliated engineering, pharmacy, and management institutes.

Uploaded by

ManKap
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Admission Form

Shambhunath Group of Institutions Registration Form


Form No.
Jhalwa, Allahabad
Affiliated By UPTU Lucknow, Approved by AICTE, New Delhi

Courses Applied for


Shambhunath Institute of Shambhunath Institute of Shambhunath Institute of
Engineering & Technology (162) Pharmacy (241) Managment (727)
B. Tech. B. Tech (Lat.) B. Pharm .
CE CS EE EN EC ME B. Pharm. (Lat.)
MBA
EC (VLSI) ME (PE) M. Pharm.
M. Tech.
Pharmaceutics
MBA Pharmacology

Personal Details
Name (Mr./Ms.)

Affix
Date of Birth (dd/mm/yyyy) passport size
Domicile UP Other than UP recent
Category (SC/ST/OBC/GEN) photograph
Blood Group Gender M F
Religion Mobile
Email-id

Father's Name (Mr./Dr./Late)

Mother's Name (Mrs/Dr./Late)

Father's/Guardian Occupation Mobile

Mother's Occupation Mobile

Correspondence Address

District State Pin Code

Permanent Address

District State Pin Code

Local Guardian Name & Address

District State Pin Code

Facilty Transportation Method


Bus Hostel None Bike Cycle Others

For Office Session Student ID


Use Only : Admission Quota Counselling Other Date of Admission
Educational Details

Name of Exam Year Passed Roll No. Board/Uni. Name of Medium Max. Obt.
Institue Marks Marks
High School

Intermediate
Diploma
for Lateral Entry Student

Graduation
Any Other Specify
______________________

Main Subjects

Obtained Marks & Percentage in Intermediate PCM/PCB Percentage

Physics Chemistry Math Biology Computer Science

UPSEE
Roll no. General Rank Category Rank

JEE (Earlier AIEEE)


Roll no. All India Rank State Rank
MAT
Roll no. Composite Scre Percentile

CMAT
Roll no. Score Rank
GATE
Roll no. Score Percentile
GPAT
Roll no. Percentile
GATE
Roll no. Percentile

Others Specify
_______________________

Roll no.

Declatarion
I hereby declare that the information given by me in this form is correct to the best of my knowledge and belief. I have not concealed
any fact or
information and I duly possess the minimum prescribed qualification. I understand that in case anything is found contradictory or false, my
admission shall be cancelled. I shall abide by all terms, conditions, rules and regulations of the college/University/Government with regards to
admissions.

Signature of Applicant Signature of Parent/Guardian

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