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Regd. No.1499

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Form No.

ASHOK NAGAR, SARKANDA, BILASPUR (C.G.)

ADMISSION FORM
SESSION : 20
For Office Use
Name of Class
Passport Admission No. .....................................
Size Date of Admission ...............................
Photo Receipt No. .........................................

Student’s Type New Old

Name (In Hindi) : .....................................................................................................

Name (In English): ......................................................................................................

Father’s / Husband’s Name :.........................................................................................

Mother’s Name : .......................................................................................................

Date of Birth Date Month Year

E-mail : ...................................... Mobile No.:....................................................

Note : Please mark ( ) sign in the correct boxes given below:

BPL : Yes No Handicapped: Yes NO Gender : Male Female Other

Caste Category : General OBC SC ST

Religion : Hindu Muslim Sikh Christian Buddh Jain Parsi Other

Stream : Arts Commerce Science Computer Social work Education Dip.

Enrollment No. if old : ............................University User ID ................................

Aadhar Card No.: ....................................................................................................................

PTO
Father’s Name / Husband’s Name : ............................................................ M ob. No.: ........................

Occupation of father / Husband : ..........................................................................................................

Permanent Address : .............................................................................................................................

................................................................................................................................................................

Present Address : ..................................................................................................................................

.................................................................................................................................................................

Local Guardian’s Address : ...................................................................................................................

Applicant is the Resident of Chhattisgarh Other State

If other State please mention : ...............................................................................................................

Details of the previous appeared Exams (10th and onwards) :

(Provide necessary documents)

School/College Board/ University Percentage

Class Roll No. Year Name
Name (%)

Name of the Course applied for : ..........................................................................................................

Name of the subjects that the applicant wants to opt. (Graduation Level)

(A) Compulsory subjects (B) Optional Subjects

(F. C.) (Any 3)
1. ................................................................ 1. ................................................................
2. ................................................................ 2. ................................................................
3. ................................................................ 3. ................................................................
4. ................................................................ 4. ................................................................
PTO
Area of Interest :
N.S.S. Gym Sports Skill Development
Through Admission / वेश का मा यम ............................................................................................................
Documents enclosed with this application :
1. Class 10th Mark Sheet 2. Class 12th Mark Sheet

3. Transfer Certificate (TC) 4. Character Certificate (CC)

5. Aadhar Card 6. Migration Certificate

7. Eligibility Certificate 8. Graduation Certificate Other Certificate

UNDERTAKING
(By Student)

I have carefully read and understood the admission policy, code of conduct, code of
ethics, policies rules and guidelines related to attendance, scholarship, examination fee
payment college leaving/transfer.
I agree and accept to abide by them absolutely. In case of conflict/ complain/
discussion / decision pertaining to me, only me or my parents / guardians signatory shall be
the representative at the college. In case of deviation / non compliance of this aforesaid
conditions, D.L.S. P.G. College shall reserve all the right to take any appropriate
disciplinary action deemed necessary against me.

Date : ....................................
Place : .................................... Student Signature

UNDERTAKING
(By Parent/Guardian)
I have carefully read and understood the admission policy, code of conduct, code of
ethics, policies rules and guidelines related to attendance, scholarship, examination fee
payment college leaving/transfer.
My ward shall agree and accept them all and commit to abide by them strictly. In case
of conflict / problems / discussion / decision pertaining to my ward, only my ward or me shall
be the representative at the college. In case of deviation / non compliance of this undertaking,
DLS PG College shall reserve the right to take any appropriate disciplinary action deemed
necessary against my ward.

Date : ....................................
Place : .................................... Parent Signature
 REMARKS OF THE ADMISSION COMMITTEE

Admission Approved Admission Denied

If denied Remarks : ...................................................................................................................

..................................................................................................................................................

Co-ordinator
Admission Committee Principal

FEE STRUCTURE SESSION – 2022-23

Sl.No. CLASS NO. OF STUDENT FEES
01. B.A. PART - I 240 7000
02. B.Com - I 160 7000
03. B.Sc. - I Biology 80 10500
04. B.Sc. - I Maths 40 8500
05. B.Sc. - I Comp. Science 40 13000
06. B.Sc. - I Microbiology 50 13000
07. B.Sc. - I (Biotech.) 20 13000
08. B.C.A. – I 50 22000
09. M.A. Pre History 40 6000
10. M.A. Pre English 50 6000
11. M.A. Pre Geography 90 6000
12. M.S.W. Previous 50 11000
13. M.Com. Previous 20 12000
14. M.Sc. Previous Physics 25 21000
15. M.Sc. Previous Chemistry 50 23500
16. M.Sc. Previous Maths 60 9000
17. M.Sc. Previous Botany 30 22500
18. M.Sc. Previous Zoology 30 23500
19. M.Sc. Previous C.S. 25 16000
20. M.Sc. Previous Micro. 25 16000
21. M.Sc. Previous Biotech. 20 16000
22. D.C.A. 80 7000
23. P.G.D.C.A. 80 18000
24. P.G. Diploma in Yoga Science 30 10000
25. P.G.D.B.M. 20 8000
26. B.Ed. Previous 100 30970

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Note : Filling this form does not ensure your admission. Admission shall be provided on the basis of merit / seat
availability. The Admission process is controlled and co - ordinate by the admission committee. All the rights are
reserved.