LN College

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Year

Course

Personal Information :

Name of the Student
(In case of changed name, write current name)

First-name

Last-name

Middle-name

Name of the Student in Vernacular Language (dovanaagari):

First-name

Last-name

Middle-name

Father's Name

First-name

Last-name

Middle-name

Mother's Name

First-name

Last-name

Middle-name

Previous name of the Student :

First-name

Last-name

Middle-name

Reason for name change

Marrital Status

Date of Birth

Gender

Place of birth

Blood Group

Religion

Citizen of (country name)

Address for Correspndence :

State

District

Tahsil

City / town / village

Address

Pin Code

Permanent Address :

State

District

Tahsil

City / town / village

Address

Pin Code

Contact Details :

Phone #1

Phone #2

Aadhar No

Email-Id

Legal Reservation Information Section :

Domicile State

Social Reservation Information Section :

Ex-Serviceman/ Ward of Ex-Serviceman
Active-Serviceman / Ward of Active-Serviceman
Freedom Fighter / Ward of Freedom Fighter
Ward of Primary Teacher
Ward of Secondary Teacher
Deserted / Divorced / Widowed Women

Member of Project Affected Family
Member of Earthquake Affected Family
Member of Flood / Famine Affected Family
Resident of Tribal Area
Kashmir Migrant
E.B.C.

Occupation of the Guardian

Educational Details Section :

Exam passed : HSC

Name of the Board / University
Name of the School / College
Date of Passing (DD/MM/YEAR
Examination Seat No. (Last)
Degree/ Passing Certificate No.
Grade/ Total Marks Obtained
Out of
ATKT/PASSED ? (Yes /No)

Exam passed : FY-SEM-I

Name of the Board / University
Name of the School / College
Date of Passing (DD/MM/YEAR
Examination Seat No. (Last)
Degree/ Passing Certificate No.
Grade/ Total Marks Obtained
Out of
ATKT/PASSED ? (Yes /No)

Exam passed : FY-SEM-II

Name of the Board / University
Name of the School / College
Date of Passing (DD/MM/YEAR
Examination Seat No. (Last)
Degree/ Passing Certificate No.
Grade/ Total Marks Obtained
Out of
ATKT/PASSED ? (Yes /No)

Exam passed : SY-SEM-III

Name of the Board / University
Name of the School / College
Date of Passing (DD/MM/YEAR
Examination Seat No. (Last)
Degree/ Passing Certificate No.
Grade/ Total Marks Obtained
Out of
ATKT/PASSED ? (Yes /No)

Exam passed : SY-SEM-IV

Name of the Board / University
Name of the School / College
Date of Passing (DD/MM/YEAR
Examination Seat No. (Last)
Degree/ Passing Certificate No.
Grade/ Total Marks Obtained
Out of
ATKT/PASSED ? (Yes /No)

Exam passed : TY-SEM-V

Name of the Board / University
Name of the School / College
Date of Passing (DD/MM/YEAR
Examination Seat No. (Last)
Degree/ Passing Certificate No.
Grade/ Total Marks Obtained
Out of
ATKT/PASSED ? (Yes /No)

Exam passed : TY-SEM-VI

Name of the Board / University
Name of the School / College
Date of Passing (DD/MM/YEAR
Examination Seat No. (Last)
Degree/ Passing Certificate No.
Grade/ Total Marks Obtained
Out of
ATKT/PASSED ? (Yes /No)

Exam passed : M-COM-SEM-I

Name of the Board / University
Name of the School / College
Date of Passing (DD/MM/YEAR
Examination Seat No. (Last)
Degree/ Passing Certificate No.
Grade/ Total Marks Obtained
Out of
ATKT/PASSED ? (Yes /No)

Exam passed : M-COM-SEM-II

Name of the Board / University
Name of the School / College
Date of Passing (DD/MM/YEAR
Examination Seat No. (Last)
Degree/ Passing Certificate No.
Grade/ Total Marks Obtained
Out of
ATKT/PASSED ? (Yes /No)

Attached Documents and Certificates Section :

Sr. No.	Name of Document / Certificate	Attached (Yes/No)
1	Passing Certificate of Std 10th
2	Passing Certificate of Std 12th/Statement of Marks of Std 12th
3	Leaving Certificate
4	Certificate of Caste with Category
5	Non Creamy Layer Certificate
6	Affidivate for changed name / Marriage Certificate / Govt. Gazzette
7	Domicile Certificate
8	Certificate for Physically Challenged
9	Adhar Card No
10	Vaccination Certificate

Guardian Information Section :

Guardian's Name

Relationship of guardian with applicant

Other Information Section :

Mother tongue

Employment Status

Do you wish to join NSS ?

Do you wish to join DLLE ?

Hobbies and Other Interests

Games and Sports participation

Level (e.g. College / State / National / International etc.)

Personal identification Marks

Online Admission Form

Personal Information :

Address for Correspndence :

Permanent Address :

Contact Details :

Legal Reservation Information Section :

Social Reservation Information Section :

Educational Details Section :

Attached Documents and Certificates Section :

Guardian Information Section :

Other Information Section :