Jai Bharath College

Application for admission to MSW/MSc-electronics,BSc-electronics,BBA,BCom-Tax/BCom-Com

	Name of the course applied for* :

1	a) Name of the Candidate*:
	b) Address to which communication are be sent
	Door No / House Name *:
	Area/Street/Road* :
	Post Office* :
	District & State* :
	Phone No. with area code* :
	Mobile No :
	Pin : E - mail :
	b) Permenent address of the candidate if different from above
	Door No / House Name :
	Area/Street/Road :
	Post Office :
	District & State :
	Phone No. with area code :
	Mobile No :
	Pin : E - mail :
	b) Nationality : Indian Other e ) Gender : Male Female
	f) Religion : g) Caste : h) Blood Group :


2	Date of Birth in Christian era : Date Month Year

3	Details of exta carriculam activities :
4	Achivements attained :
5	Details of scholarships/ award obtained :

6	a) Name of Parent/Guardian:
6	b) Address of Parent/Guardian:
	Contact No (Tel/Mob) :
	e-mail address if any :
	c) Occupation of Parent/Guardian :
	d) annual income of Parent/Guardian :

7	Are you native of Kerala : Yes No

8	a) Name of qualifying examination : [BA/B.Sc/B.Com/B.Tech etc.]	Appeared / Passed
	b) Name of University or Board :
	c) Register Bo./Month/Year :
	d) Name of Institution in which studied :
	e) Number of chances availed for the qualifying examinations :

9	Are you employes ? Details of employmnet ?

10	Any other feature for special consideration ?

11	Reservation Particulars
	Are you eligible for reseravtion under any category (Yes/No) :
	If yes , Specify Community /Category:
	(Management Quota/SEBC/SC/ST/any Other (Specify)):