Azad Degree College
(affiliated to lucknow university)
Phone :- 91-522-2817608,91-9236240859

  
 

ADMISSION FORM

 
   
 

 

course opted *
Full Name: Mr./Ms/Mrs.*
father's name/husband  Name: *

Profession/Business

Designation

Name & Address of Organization

Mother's Name *

Date of Birth *

Sex* :    Male      Female

Mailing Address *

Mobile No.

                Phone No. (O)   Mobile (R)

Permanent Address *

Mobile No.

              Phone No. (O)   Mobile (R)

Category (Gen./SC/ST/OBC)*  *

                Nationality     

Are you an NRI (Yes/No)

    If yes Country of domicile 

Do you require Hostel Accomodation Yes/No.    

Academic Qualification*
School/ College
Exam passed
Year
Subject
% of Marks

 
   
(Attested copies of the Certificates & Mark sheets of the Examinations should be enclosed with the Print Out of application form)
   
Scholarships, Medals and Prizes
Extra Curricular Activities/Hobbies
   
Details of Fee*
Bank Draft No.
Date                             Issuing Bank & Branch 
Amount Rs.                                    Receipt No.  
 
The Following documents are to be submitted with the Print out of completed admission form :
1.  10 Passport size Photographs.
2.  Self Attested sets of certificates & marks sheets of Examinations passes.
3.  Caste certificate by SC/ST/OBC students.
4.  Affidavit for GAP
5.  Migration/Transfer Certificate.
6.  Income Certificate of parents/Guardian from all category students (SC/ST/OBC/GEN)