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Admission Form

Course

Course year

Date of Birth
Sex
Place Of Birth Village
District
State
Caste
Category
Religion
Minority
Want to apply for EBC
DTE UserId
DTE Password

Father Information

Occupation of Father/Guardian:
Anual Income: Rs
Local Address:
Tal:
Dist:
PIN:

Permanent Address

Permanent Address:
Tal:
Dist:
PIN:
Student Mobile Number:
Email Address:
Student Wtatsapp Number:
Parents Mobile Number:
Student Aadhaar (UID):
CAP Round:
Appointment Letter No.:

ACADEMIC RECORD

Exam Name & Address of the Institute (Dist.) Board Month & Year of Passing Marks Obtained / Max-Marks % of Marks
SSC
HSC
B.Pharma
D.Pharma

Documents Attached & Required

1. SSC Mark Sheet / Certificate

2. HSC Mark Sheet / Certificate

3. Diploma Mark Sheet

4. Leaving Certificate

5. Mark Sheet / Certificate

6. Age Certificate

7. Nationality Certificate

8. Domicile Certificate

9. Income Certificate

10. Caste Certificate

11. Caste Validity Certificate

12. Non Creamy Layer Certificate

13. Proforma Z / N

14. 5 Photographs (Passport)

15. Document Photocopy Set

16. Allotment Letter

17. Gap Certificate (if Applicable)

18. Aadhaar Card (Xerox)


Documents Verified & Received by




 Date: /   /20 Name & Signature  


Undertaking


I Guardian of do hereby state in sole affirmation that my ward has taken admission for Diploma Course Shantiniketan College of Pharmacy, Dhotre B. tc.
in the branch of Pharmacy during Academic Year 2024-25.
College authorities and the change made therein from time to time within prescribed time limit, faling to which the admission of my ward may be treated as cancelled.
(Fees Details Rs. )

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