b.ed,d.pharmacy form
TRANSCRIPT
7/27/2019 B.ed,D.pharmacy Form
http://slidepdf.com/reader/full/beddpharmacy-form 1/1
……………………………………………………………………………………………………………………………………………………………………
TIRUPATI GROUP OF INSTITUTIONSRatia - Sardulgarh Road, RATIA (FATEHABAD) HARYANA
Admission FormS. No.:---- Specimen Copy-----
Name:………………………………………………………………………
Father’s Name:…………………………………………….………………..
Mother’s Name:…………………………………………………………….
Sex (Male/Female):…………………………………………………………
Date of Birth:…..………………………… Category ……………………...
Haryana Resi./Others:……………………. Religion.………………………
Address for Corres pondence:………………………………….………………………………………………
Village……………………………………………P.O:……………………………………………………….
Distt:..……………………………………………State:………………………………………………………
Pin Code…………………………………………Phone/Mobile No..…..………….…………........................
Courses: B. Ed. D. Ed. D. Pharm. Diploma in Civil Engg.
Diploma in Elect. & Comm. Engg. Diploma in Mech. Engg.
Diploma in Civil Engg. (Lateral Entry) Diploma in Mech. Engg. (Lateral Entry)
Diploma in Elect. & Comm. Engg. (Lateral Entry)
Educational Qualification:
Examination
Passed
Board/
University
Month &
Year
Reg. No. Subject
Studied
Marks Obt/
Max. Marks
% age
Matric
Senior Secondary
Graduation or anyEquivalent
Qualification
Post Graduation or any Equivalent
Qualification
Any Other
DECLARATION:
I hereby solemnly affirm and declare that information given in admission form is correct and true to the best of my knowledge and belief. I further declare that I have not concealed any information & eligible for admission
as per eligibility conditions and policy declared in the prospectus issued by Haryana Govt./C.D.L.U., Sirsa/ NCTE, New Delhi/ SCERT, Gurgaon/HBSE, Bhiwani/Directorate of Technical Education, Panchkula/HSBTE,
Panchkula/PCI & AICTE New Delhi. If at any stage any information provided/given by me is found false andincorrect my admission in the concerned course shall stands cancelled and legal proceedings may initiated
against me as per the court of law.
Signature of Student Date:………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
For Of fi ce Use Only
Checked By: Signature with seal of
Principal/Chairman
Affix latest Passport
size photograph in
the box