Application For Admission

    Affilited To S.N.D.T Women’s University Mumbai

    Umang Geetai College of Women’s Education

    College Code

    0425

    For College
    Use Only

    Kindly Read Important Notes Before Filling-in-Form

    • Fll the form carefully

    • Fll all fields

    • Strike off Which is Not Applicable

    Medium : MarathiHindiEnglish

    Admitted against which Category :OpenReserved

    1 Personal Information Section

    Name of Students

    Name of the students as printed on STD.X Passing Certificate

    Father’s/Husband Name

    Mother’s Name

    Previous Name of the students (In case of change Name)

    Reason For Change Name :WillinglyAfter Marriage             Martial Status :UnmarriedMarriedDivorceWidow

    Student’s Location Category : RuralUrbanTribal

    Address for Correspondence

    CityTownVillage

    Permanent Address (Write only if different than ” Correspondence Address”)

    CityTownVillage

    Contact Detalis

    Category : OpenReserved

    If Reserved : SCST(A)NT(B)NT(C)NT(D)WJSBCOBC

    If Physically Challenged : Visually ImpairedSpeech and or Hearing ImpairedOrthopedically ImpairedLearning Disabled

    Ex-Serviceman / Ward of Ex-ServicemanActive-Serviceman / Ward of Active-ServicemanFreedom Fighter / Ward of Freedom FighterWard of Primary School TeacherWard of Secondary School TeacherDeserted / Divorced / Widowed Women

    4 Guardian Information Section

    ServiceBusinessProfessionFarmerLaborPrivate

    5(A) Educational Details Section : Last Qualifying Exam Details : (In case of Degree Mention Major & Subsidiary Subject)

    Name of Last Qualifying Examination :

    5(B) Scholarship Details Section :

    Student Username :

    Student Password :

    6 Select Subjects : Please attach seprate sheet giving subjects option form

    7 Attach Documents and Certificate Section :

    Sr.No.

    Name of Documents & Certificates

    Original/Attested True Copy

    Attached (Yes/No)

    1

    Passing Certificate of STD. X, XII

    Original(Mandatory)

    2

    Passing Certificate of Last Qualifying Exam

    Attested True Copy

    3

    Leaving Certificate

    Original

    4

    Certificate of Caste with Category (If Applicable)

    Original True Copy

    5

    Non Creamy Layer Certificate (If Applicable)

    Original True Copy

    6

    Affidavit of Changed Name/Marriage Certificate/ Govt. Gazatte (If Applicable)

    Original True Copy

    7

    Domicile Certificate, Bank account No. (If Applicable)

    Original True Copy

    8

    Income Certificate

    Original True Copy

    9

    Aadhar Card

    Original True Copy

    10

    Colored Passport Size Photo

    Original True Copy

    10

    Signature

    Original True Copy

    8 Other Information Section

    Employee Status : EmployedUnemployed

    Do you wish to join NCC/NSS : YesNo

    Would you like to apply for hostel : YesNo

    Bus Facility : YesNo

    Game & sports Participation :

    Personal Identification Marks:

    9 Declaration by Student :

    I have declare that, I have read rules releated to admission and the information filled by me in this form is accurate and true to the best of my knowledge. I will be responsible for any discrepancy arising out of the form signed by me and I undertake that, in absence of any document, the final admission will not be granted and/or admission will stand cancelled. I am aware of Maharashtra Prohibition of Ragging Act 1999, and I State that I will abide by all the rules and regulations of the said Act.

    10 Declaration by Guardian :

    I have permitted by daughter/son/ward to join your college. The Inforamation Supplied by her/him is correct to the best of my knowledge. I have acquainted myself with the fees, dues and rules applicable to my daughter/son/ward and to see that she/he observers them.

    A/C Name:- UMANG GEETAI COLLEGE OF WOMEN’S EDUCATION

    Bank Name:- Punjab National Bank

    A/C No:- 08971131000806

    IFSC Code:- PUNB0089710

    Branch:- WCL JARIPATKA, NAGPUR