(College Copy)
G. D. Binani Post Graduate College, Application
Form No./Roll
Mirzapur, Uttar Pradesh No.
40623810455
Admission Permission Letter (2024-25)
महािवालय पिरसर म माक और ह ड सै िनटाइजर का योग अिनवाय है ।
वे शाथी आवे दन प की हाड कॉपी, हाईकू ल इं टरमीिडएट अं कप, टी० सी० / चिर माण प, िपछले का का अं कप एवं तीन रं गीन पासपोट
साइज फोटो समत सलनको की मूल छाया ित काउं सिलं ग के समय अवय साथ लाये
A. Student Details
Course: B.A. YEAR-3-SEM-6
Major : (ANCIENT INDIAN HISTORY, CULTURE AND ARCHAEOLOGY),(ENGLISH)
Candidate's name: SHALU SHUKLA Father's name: DINESH KUMAR SHUKLA
Mother's name: ASHA DEVI
Guardian's Name: DINESH KUMAR SHUKLA Relation: Daughter
Date Of Birth: 05-08-2003 Gender/Sex: Female
Category: Unreserved Domicile : Uttar Pradesh
Residential Address Permanent Address
Address : VINDHYAVASINI COLONY BHARUHANA, DIST Address : VINDHYAVASINI
MIRZAPUR COLONY BHARUHANA, DIST
State : Uttar Pradesh MIRZAPUR
District : Mirzapur State : Uttar Pradesh
Pin Code : 231001 District : Mirzapur
Pin Code : 231001
Phone : 9792089004 , Email : guptadilipkumar477@gmail.com Signature
Payment Details
FeeType Date TxnId Status Amount Payment Mode
Admission Form Fee 21-04-2025 11000274295778 PAID 250 ONLINE
FeeType Date TxnId Status Amount Payment Mode
Course Fee 21-04-2025 11000274297347 PAID 850 ONLINE
F. Declaration
I solemnly declare that all the information made above are true to the best of my knowledge and belief. If any information is found
incorrect, my candidature can be cancelled.
Signature of the Candidate
Signature of Father/Guardian
For Office Use Only
Signature of Admission Committee Signature of Proctor Signature of Principal
महािवालय रै िगंग मु त पिरसर है | (The college is a ragging free campus)
1
(Student Copy)
G. D. Binani Post Graduate College, Application
Form No./Roll
Mirzapur, Uttar Pradesh No.
40623810455
Admission Permission Letter (2024-25)
महािवालय पिरसर म माक और ह ड सै िनटाइजर का योग अिनवाय है ।
वे शाथी आवे दन प की हाड कॉपी, हाईकू ल इं टरमीिडएट अं कप, टी० सी० / चिर माण प, िपछले का का अं कप एवं तीन रं गीन पासपोट
साइज फोटो समत सलनको की मूल छाया ित काउं सिलं ग के समय अवय साथ लाये
A. Student Details
Course: B.A. YEAR-3-SEM-6
Major : (ANCIENT INDIAN HISTORY, CULTURE AND ARCHAEOLOGY),(ENGLISH)
Candidate's name: SHALU SHUKLA Father's name: DINESH KUMAR SHUKLA
Mother's name: ASHA DEVI
Guardian's Name: DINESH KUMAR SHUKLA Relation: Daughter
Date Of Birth: 05-08-2003 Gender/Sex: Female
Category: Unreserved Domicile : Uttar Pradesh
Residential Address Permanent Address
Address : VINDHYAVASINI COLONY BHARUHANA, DIST Address : VINDHYAVASINI
MIRZAPUR COLONY BHARUHANA, DIST
State : Uttar Pradesh MIRZAPUR
District : Mirzapur State : Uttar Pradesh
Pin Code : 231001 District : Mirzapur
Pin Code : 231001
Phone : 9792089004 , Email : guptadilipkumar477@gmail.com Signature
Payment Details
FeeType Date TxnId Status Amount Payment Mode
Admission Form Fee 21-04-2025 11000274295778 PAID 250 ONLINE
FeeType Date TxnId Status Amount Payment Mode
Course Fee 21-04-2025 11000274297347 PAID 850 ONLINE
F. Declaration
I solemnly declare that all the information made above are true to the best of my knowledge and belief. If any information is found
incorrect, my candidature can be cancelled.
Signature of the Candidate
Signature of Father/Guardian
For Office Use Only
Signature of Admission Committee Signature of Proctor Signature of Principal
महािवालय रै िगंग मु त पिरसर है | (The college is a ragging free campus)
