Passport Size Photograph

SREE VIDYANIKETHAN DEGREE COLLEGE (Affiliated to S.V. University)

(Accredited by National Assessment and Accreditation Council NAAC) Sree Sainath Nagar, A. Rangampet, Near Tirupati

Chandragiri (M) Chittoor District 517 102. Website: www.vidyanikethan.edu

Phone : 0877 2236711 (4 Lines); 2236715 Application No. :

Registration No. : Course Applied: B. Sc / B. Com (CA) / B.C.A

Group in which admission is sought : (M.S.Cs / M.E.Cs / Bt. Z.C / Mi. Bi.C/ M.P.C) Second Language : Telugu / Sanskrit

SURNAME FULL NAME 1. Name of the Candidate in full :

(as entered in S.S.C.) (BLOCK LETTERS)

2. Gender : Male / Female 3. Fathers Name : 4. Occupation :

5. Annual Income :

6. Address

Date Month Year

7. Date of Birth as entered in T.C. / Marks Memo :

8. Qualifying Examination Passed : Intermediate 9. Group studied in qualifying examination : Bi. P. C / M. P. C / C. E. C / H. E. C / M.E.C

10. Medium of instruction studied : English / Telugu

11. a. Community : OC/BC-A/ BC-B/ BC-C/BC-D/SC/ST/Minorities

b. Religion :

c. Nationality :

Address for communication

PIN:

Ph. No.

e-mail:

Permanent address

PIN:

Ph. No.

e-mail:

12. Details of Qualifying Examination a. No. of Attempts : b. Institution last studied : c. Class obtained and percentage of marks :

Group Subjects

I II III IV Year English Second

Language

Total Marks

I Year

II Year -Theory

II Year -Practical - -

GRAND TOTAL

DECLARATION BY THE STUDENT

I declare that the particulars stated above are true and correct, I solemnly affirm that, if admitted, I will abide by the rules and regulations governing the students of the College. Place: Date : SIGNATURE OF THE APPLICANT

UNDERTAKING BY PARENT / GUARDIAN I, hereby affirm that my son / daughter / ward will:

a. Abide by the rules and regulations of the College and Hostel.

b. Carry out all orders / instructions issued by the Principal and Faculty and any other competent authority from time to time.

c. Participate in all curricular, co-curricular and extra-curricular activities. d. Attend classes regularly. e. Conduct himself / herself exemplarily and behave with dignity, decency, discipline and

decorum. f. Pay the Tuition Fees on time and attend the classes regularly, maintaining a minimum of 75%

attendance. g. Pay Tuition Fee for the rest of the years In the event of leaving the College in the middle.

h. Abide by any action taken by the College authorities in case of non-compliance of the items (a) to (f) mentioned above.

SIGNATURE OF THE PARENT / GUARDIAN

INSTRUCTIONS

1. Application is to be filled by the Candidate in his / her own handwriting 2. Application which is incomplete or wrongly filled or received after the last date will be

rejected.

3. Right of admission is reserved. The Management has the right to admit or refuse admission without assigning any reason.

4. Fee once paid will not be refunded under any circumstances.

I. To be submitted with the application form

1. Three Latest passport size photographs. 2. Two Xerox copies of all the certificates.

II. To be submitted at the time of admission

1. Transfer Certificate in original. 2. Pass Certificate and Memorandum of Marks statement (S.S.C & Intermediate) in original. 3. Study & Conduct Certificate in original.

FOR OFFICE USE ONLY

Admit in B. Sc / B.Com (C A)/ B.C.A Course with Group _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Second Language _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Date:

Verified: PRINCIPAL

NOTE: - The Registration Fee for downloaded application is Rs.300/- (Application Fee Rs.100/- and Registration Fee Rs.200/-) payable by cash or DD drawn in favour of The Principal, Sree Vidyanikethan Degree College, Sree Sainath Nagar, Tirupati 517 102, payable at Tirupati.