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 / Division10th
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 / YearCLASS 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 )