ARBA SUPER50

Admission

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Admission

ARBA DASWANI(Kota) SUPER50

PROVISIONAL ADMISSION FORM

Integrated Programme (2024-2025)

Receipt No :

Form No :

Session :

Mobile :

1. Name of the Applicant :

2. ARBA Daswani Super 50 Scholarship obtained :

% :

3. Date of Birth (Certificate to be enclosed) :

4. Aadhar No (Photo copy to be enclosed) :

5.(a) Gender :

(b). Religion :

(d). Weight (in KG) :

(e). Blood group :

(f) Caste (Certificate to be enclosed) :

(g). Sub Caste :

(h) Whether BPL beneficiary :

6. (a) Name of Father :

(b) Occupation:

7. (a) Name of Mother :

(b) Occupation:

8. Present Address-Vill/Town :

Ward No :

P.O :

PS :

G.P :

LAC :

Dist :

State :

PIN :

WhatsApp No :

9. Permanent Address-Vill/Town :

Ward No :

P.O :

PS :

G.P :

LAC :

Dist :

State :

PIN :

10. Hostel Facility :

11. Trasport Facility :

if Yes, Distance :

KM. Bus Stop :

13. (a)Name of the institution studied last :

(b). UDISE code of the institution studied last :

(c). Permanent Education No (PEN) :

14. Marks obtained(in percentage) in the previous class :

DECLARATION

We hereby declare that the particulars furnished are correct. We declare that the admission may be cancelled and installment paid by us forfeited if any of the particulars given by us at the time of admission are subsequently found to be wrong, concealed or false.

We agree to abide by the Academy rules and regulations and other instruction that may by issued from time to time.