Scribd
Upload
60 views1 page

Application Form For Allied

Uploaded by

shree.igpcop
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
60 views1 page

Application Form For Allied

Uploaded by

shree.igpcop
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
You are on page 1/ 1

NEET-UG-2024 Admission for State Quota Seats (85%)

Application Form for Institute Level Round for BPTH


Courses in Private Unaided/Minority Colleges Academic Year 2024-25

Name of College/Institute :
Course Name : Please Mentioned Name of the Course

1. Name of the Candidate : Surname First Name Middle Name

2. Date of Birth : DD / MM /YYYY

3. Gender :

4. CET-CELL Application No :

5. NEET Roll No. :

6. NEET Counselling Rank : All India Rank as per Merit List :

7. NEET Score/Marks : /720

8. HSC PCB marks : /300

9. Category of the Candidate :


Minority Status (Yes/No) : Linguistic : 1) Hindi 2) Gujarati
10.
Religious : 1) Muslim 2) Jain
11. Mobile No. of the Candidate :

12. E-mail ID of the Candidate :


Address for Correspondence :
13.

I am submitting Mandatory : 1) 07)


Xerox copies of all essential 2) 08)
documents as per NEET UG 3) 09)
14. 2024 Information Brochure 4) 10)
along with Application 5) 11)
Form. 6) 12)
I have All Original Documents & College Fees as per Information Brochure. I will submit All
Original Document at the time of Admission.

Date : / /2024 (Signature of the Candidate)

--------------------------------------------------------------------------------------------------------------------------------------------------
Acknowledgement
Received Application Form for Institutional Level Round (85% State Quota Only) for A.Y. - 2024-25
from Name _____________________________________________ AIR ______________________________

Date : / /2024 (Signature of the Concern Officer with Stamp)

You might also like