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Domestic Students

This document is a prescribed application form for domestic students applying to an institution. It requests biographical information such as name, date of birth, address, contact details, educational qualifications, work experience, extracurricular activities, projects undertaken, and project preferences. The applicant must sign to certify the information is true. Section 2 is for the previous institute/university to authenticate the information provided in section 1.

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Dhirendra Singh
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60 views2 pages

Domestic Students

This document is a prescribed application form for domestic students applying to an institution. It requests biographical information such as name, date of birth, address, contact details, educational qualifications, work experience, extracurricular activities, projects undertaken, and project preferences. The applicant must sign to certify the information is true. Section 2 is for the previous institute/university to authenticate the information provided in section 1.

Uploaded by

Dhirendra Singh
Copyright
© Attribution Non-Commercial (BY-NC)
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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Prescribed Application Form - Domestic Students

Name & Full Address of :


Latest passport size
the institution
photograph of the
student

Institute’s Phone No.:


1. B I O – D A T A

Full Name : Mrs/Ms/ /Mr:


(Surname first)

Date of Birth : Age :

Full Postal Address :


for communication

Telephone No. Institution :


Residence :
Mobile :
E-mail :

Educational Qualifications:
Exam Univ./Institute Year of % of Subjects
Passing Marks (Arts/commerce/
Science/Tech. Etc.)

Additional qualifications
(CA/ICWA/Computers, etc.)

Subjects of Specialisation / Interest :

Work Experience :
Extra Curricular Activities :

Projects undertaken :

Project Preferences : (Please note that it may not always be possible to allocate
project of your choice)

I certify that the above information furnished by me is true to the best of my


knowledge and belief.

Place : Signature :

Date : Name :

2. Authentication of particulars furnished in (1) above by the


Institute/University

This is to certify that the information furnished by Mr./Ms/Mrs.--------------------------------

----------------- in the form of application at (1) above is correct to the best of our
knowledge.

Recommendations, if any

Signature & Seal of


Authorised Official

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