52

Application form for BCA/BBA/IMB Course

Course Name: IMB
Application Form No. 101072
Date of Submission 19 January, 2021

Personal Details

Name of Student 52
Father/Husband name Deisy
Mother name Janiah
Date of Birth 24-02-1980
Gender Male
Reservation Category WBC
Mobile No. 2704369327
Marital Status Unmarried
Physically Challenged(PH) Yes
Aadhar Number 39
Email id sawtpixelsyn@limedyenicok.site
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Intermediate Details

Name of College Carina
Board 17
Year of Passing 45
Percentage of Marks 63

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.