Calorx Teachers’ University

Greenwud, Vaishno Devi Circle,

Sardar Patel Ring Road, Ognaj,

Ahmedabad, Gujarat

Reg. No.: ______REGISTRATION FORM Office Use

(Use Block Letters) Admission No.: ______

(Receipt No.) : ______

COURSE APPLIED FOR: ______

1.  Candidate’s Name:

FIRST NAME MIDDLE NAME SURNAME

______

2.  Residential Address:

______

______Pin: ______

Tel No. (R): ______Tel No. (M): ______

Email id ______

3.  Date of Birth (In Figures): ______Male/Female ______

4.  Nationality ______

5.  Details of Educational Qualifications:

Sr. No / Educational
Qualifications / Board / Medium of Instruction / Name of School / Subjects / Percentage of Marks
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6. Father’s Name: ______

Academic Qualifications: ______

Office Name & Address: ______

______

Occupation: ______Designation: ______

Tel. No. ______E-mail: ______

7. Mother’s Name: ______

Academic Qualifications: ______

Office Name & Address: ______

______

Occupation: ______Designation: ______

Tel. No. ______E-mail: ______

FOR HOSTEL

Details of the Guardian

Name______

Relationship with the Student ______

Address ______

______

Mobile______Residence No.______Email: ______

Favourite Sports ______

Favourite Hobbies ______

Medical Details (Please mention serious illness or allergies if any):

______

______

Write a personal statement in 100-200 words about the “Importance of a Teacher in Society”.

INSTRUCTIONS

1.  Leaving Certificate in original will be required for admission.

2.  Attested copy of Class XII Mark Sheet to be submitted.

3.  Recent Certificates, awards, citations etc.

4.  Two passport size photographs.

5.  Attested copy of Birth certificate.

Director

AGREEMENT

I, the undersigned, bind myself and my ward to abide by the University’s rules & regulations in all respect. I understand that the rules & regulations may be changed or new rules may be introduced by the University from time to time. In all matters of dispute the decision of the Director of the University will be final and binding on me and my ward. In case of gross violation of rules, I shall withdraw my ward, if the university so desires.

Date: ______

Signature of Parent / Guardian

Please return this form duly filled in, latest by ______

(University Stamp)

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