Department of Higher Education :: APPLICATION FOR ADMISSION http://admission.highereduhry.com/web/index.php/preview/form/A1753...

The portal is open for online admission to the college only if the seats are
vacant in the given course. In case seats are not available there will be no claim
for admissions.

Print Date: 07/07/2017

S.D College (Lahore), Ambala Cantt Registration Date: 07/07/2017

Session 2017-18 Form

No.A17534822554938/Registration
APPLICATION FOR ADMISSION Number: R172160932402

For Office Use

Class
Roll No.
Admission Form Fee
Receipt
Date
Signature

Course : M.Sc Class/Semester : M.Sc(Maths) -I

Date of
Applicant's Name : Dalbir Singh Birth(DD/MM : 04/03/1995
/YYYY)
Gender : Male Father's Name : GURDYAL
Father's
: No Occupation Blood Group : O+
Occupation
Mother's Name : BABY DEVI Category : General
Mother's
: House Maker Religion : Hindu
Occupation
BPL Card No. : Mode of Transport : Public Transport
Caste : GENERAL Marital Status : Single
Are you
Is Haryana
Employed at :N/A : YES
Domicile
Present
Nationality : Indian Gap Year (if any) :
Annual Income of
:60000 Guardian's Name :
Family

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Department of Higher Education :: APPLICATION FOR ADMISSION http://admission.highereduhry.com/web/index.php/preview/form/A1753...

Have ever been

Bank Account
disqualified from :N/A :4757101002007
Number
any Exam
Whether
Applying for :NO Bank Name :Canara Bank
Hostel
Aadhar Number : 207140953539 IFSC Code :CNRB0004757
ADDRESS DETAILS
: VILL-GADWALI,P.O-CHOULI(RAMPUR),DISTT-YAMUNA
Address
NAGAR,M.NO-9468067047
State :HARYANA District :YAMUNANAGAR
Pin Code :135102 Email Id :DALBIR46@GMAIL.COM
Land Line No. :N/A Mobile No. :9468067047

EDUCATION QUALIFICATION
Exam School/College Reg/Roll Passing Result Max Marks
Percentage
Passed Name No Year type Marks Obt
GOVT COLLEGE
UG 0003373866 2017 PASSED 2900 1954 67.38
CHHACHHRAULI
GOVT MODEL
SANSKRITI SR
12TH -
SEC SCHOOL
Non 3212311630 2013 PASSED 500 365 73
BILASPUR
Medical
YAMUNA
NAGAR
SHRI KRISHANA
SR SEC
SCHOOL,
10TH 2210818934 2011 PASSED 600 393 65.5
ALISHER PUR
MAJRA YAMUNA
NAGAR

SUBJECT OFFERED
Preference Subjects

WEIGHTAGE
Candidate who have secured 60% marks/ CGPA 6.0 on 10 points scale from
YES
qualifying exam.

DOCUMENTS TO BE ATTACHED

a) Original Character Certificate (From Institute/School Last attended) In case of Gap

Year/Private Candidate - Issued by Sarpanch/M.C/Any Gazetted Officer.
b) Matric Certificate (On Copy)

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Department of Higher Education :: APPLICATION FOR ADMISSION http://admission.highereduhry.com/web/index.php/preview/form/A1753...

c) +2 Certificate(2 Copies)
d) Migration Certificate (Original and One Copy)
e) Mark Sheet of Last Qualifying Exam (One Copy)
f) S.C/B.C./S.T/BPL Certificate (One Copy)
g) Haryana Domicile for Reserved Categories
h) Gap Year Candidate to attach affidavit as per Prospectus.
i) Any other Certificate(Specify)
j) Photocopy of Bank Account No. or Aadhaar Card/E-ID.
k) Any other relevant document for claim of weightage like NCC/NSS/Sports Rural Area
etc as per prospectus.

I hereby declare that I had gone through the provisions mentioned in Haryana Education
Institutions Antiragging Act (2012) and I will adhere to all the provisions mentioned in the
Act and will not indulge in any activity which falls under the clause of ragging as per the
Act.

Parent's Signature

Student Signature

Reciept

Received application from Mr./Ms Dalbir Singh Class M.Sc(Maths) -I Form No.
A17534822554938

Date_________________

Student Signature

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