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52

Application form for BCA/BBA/IMB Course

Course Name: BCA
Application Form No. 101044
Date of Submission 17 January, 2021

Personal Details

Name of Student 52
Father/Husband name Fatimah
Mother name Laurel
Date of Birth 28-06-1981
Gender Male
Reservation Category WBC
Mobile No. 2704369327
Marital Status Unmarried
Physically Challenged(PH) Yes
Aadhar Number 21
Email id sawtpixelsyn@limedyenicok.site
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Intermediate Details

Name of College Phyllis
Board 97
Year of Passing 45
Percentage of Marks 94

Payment Details

Payment Status

UNPAID

Declaration

1. I have filled the application form with full consideration and all the information on this form is true to the best of my knowledge.
2. I promise that I will have good and mannered behavior during the study period.
3. I agree with the rules, instructions, and other policies of the college and in case I don't follow the rules, I may be punished by the college.
4. I will be very much careful about my presence in the classroom. If I don't follow the rules related to the attendance and test examination, I am ready to accept the punishment.