(College Copy)
G. D. Binani Post Graduate College, Application
Form No./Roll
Mirzapur, Uttar Pradesh No.
40624810052
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-2-SEM-4
Major : (ENGLISH),(SOCIOLOGY),(HISTORY)
Candidate's name: ANKITA Father's name: SUNIL KUMAR MISHRA
Mother's name: SUMAN DEVI
Guardian's Name: SUNIL KUMAR MISHRA Relation: Daughter
Date Of Birth: 25-04-2006 Gender/Sex: Female
Category: Unreserved Domicile : Uttar Pradesh
Residential Address Permanent Address
Address : Pakka Pokhara Post Sadar Mirzapur , Thana City Kotawali Address : Pakka Pokhara Post
State : Uttar Pradesh Sadar Mirzapur , Thana City
District : Mirzapur Kotawali
Pin Code : 231001 State : Uttar Pradesh
District : Mirzapur
Pin Code : 231001
Phone : 9451040421 , Email : ankitamishra40555@gmail.com Signature
Payment Details
FeeType Date TxnId Status Amount Payment Mode
Admission Form Fee 20-04-2025 11000274049740 PAID 250 ONLINE
FeeType Date TxnId Status Amount Payment Mode
Course Fee 20-04-2025 11000274099074 PAID 1100 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.
40624810052
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-2-SEM-4
Major : (ENGLISH),(SOCIOLOGY),(HISTORY)
Candidate's name: ANKITA Father's name: SUNIL KUMAR MISHRA
Mother's name: SUMAN DEVI
Guardian's Name: SUNIL KUMAR MISHRA Relation: Daughter
Date Of Birth: 25-04-2006 Gender/Sex: Female
Category: Unreserved Domicile : Uttar Pradesh
Residential Address Permanent Address
Address : Pakka Pokhara Post Sadar Mirzapur , Thana City Kotawali Address : Pakka Pokhara Post
State : Uttar Pradesh Sadar Mirzapur , Thana City
District : Mirzapur Kotawali
Pin Code : 231001 State : Uttar Pradesh
District : Mirzapur
Pin Code : 231001
Phone : 9451040421 , Email : ankitamishra40555@gmail.com Signature
Payment Details
FeeType Date TxnId Status Amount Payment Mode
Admission Form Fee 20-04-2025 11000274049740 PAID 250 ONLINE
FeeType Date TxnId Status Amount Payment Mode
Course Fee 20-04-2025 11000274099074 PAID 1100 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)
