MAHATMA JYOTI RAO PHOOLE UNIVERSITY

MJRP Knowledge Campus:SP 2 & 3, Kant Kalwar, RIICO Industrial Area, NH-8, Achrol, Jaipur Ph 01426-222951,52,53

application

for Admission

Session 201_ - 201_

UG/DIPLOMA/CERTIFICATE COURSE

OFFICE RECORD

Form No ______Faculty/ Course Applied ______

Date of Submission of Application ______

Name of the Faculty______

Subjects Offered:

1.  ______2. ______3. ______4.______

4. ______6. ______7. ______8. ______

APPLICANT’S INFORMATION

Name______

Applicant’s Date of Birth______Place of Birth______

Category: SC______ST______OBC______General______

Father’s Name______Occupation ______Ph______Mob______

Husband’s Name______Occupation ______Ph______Mob______

Mother’s Name______Occupation______Ph______Mob______

Father’s Date of Birth______Mother’s Date of Birth______

Postal Address______

______

Email-ID______

Hostler /Day Scholar______

Local Guardian Name and Address______

Ph. Mobile

SCHOLASTIC RECORD

Academic Record / University/ Board / Year of Passing / Total Marks Obtained / Maximum Marks / Percentage of Marks / Division
10th
10+2
Others

MAHATMA JYOTI RAO PHOOLE UNIVERSITY

DECLARTION

I declare that all information in my application is complete, factually and honestly correct. I have read the rules and regulation mentioned in the prospectus and will adhere to and abide by the same. I also understand that fees once paid will not be refundable under any circumstances.

I______father/ guardian of______undertake guarantee of 75% attendance in the academic session of my daughter/ son.

Signature of Candidate Signature of Parent/ Guardian

Date……………….. Date………………………

ACTIVITIES

S.No. / Achievements / Year

CLASS AND FACULTY ALLOTED

( For University use only)

Receipt No.______Date______Faculty______Class______

Total Amount______Cash______

Bank Name______Cash/ Cheque No.______

Cashier Signature______

DETAIL OF DOCUMENTS

Documents Submitted: Documents Returned:

OMS______TC______MIG_____ OMS______TC______MIG______

Bonafied_____ Caste Certificate____ Bonafied_____ Caste Certificate____

DOB______Any Other______DOB______Any Other______

Received By Receiver’s Signature


MAHATMA JYOTI RAO PHOOLE UNIVERSITY

LIBRARY SLIP

(To be filled by the Candidate)

Session 201____201____

Form No : ______

Name ______

Date ______

Father’s Name ______Class ______

Local Address ______Faculty ______

______

Phone No. ______Mobile No. ______

Signature of Candidate

------

ADMISSION FORM RECEIPT

(To be filled by the Candidate)

Session 201____201____

Form No : ______Date ______

Name ______Class ______

Father’s Name ______

Local Address ______Faculty ______

______

Phone No. ______Mobile No. ______

Signature of Receiver

DOCUMENTS REQUIRED AT THE TIME OF ADMISSION

1.  Original T.C.

2.  Original migration certificate.

3.  Original Bonafide certificate.

4.  Original Caste certificate.

5.  Original mark sheet of last qualifying and 3 photocopies of it.

6.  Photocopy of 10th marksheet.

7.  4 passport size photographs.

8.  Post dated cheques along with the admission fees. (If applicable)

9.  The penalty of Rs.100 per cheque would be charged from the student if the cheque gets bounced.

10.  Original fees slip with them safely till the end of the session.

FEES ONCE DEPOSITED WOULD NOT BE REFUNDED

(Adm. Office: Ram Nagar Ext., New Sanganer Road, Sodala Jaipur, Ph 0141-2295101, 2294680 Fax-0141-2294947 )