Admission to Under Graduate Programme

Name of the Applicant (In Block Letters as in SSLC Certificate & Aadhar Card)

Tick ( √) the course applying for:

B.Sc. Psychology, Computer Science, Journalism, B.A. Journalism, Optional English and Psychology

Applicant Email ID

Date of Birth

Gender:

Place of Birth Village, City, District and State

Religion

Blood Group

Nationality

Contact Numbers:

Aadhaar Card No.

Permanent Address

Address for Correspondence

Father’s Name

Father’s Occupation

Father’s Mobile number

Father’s Email Id

Mother’s Name

Mother’s Occupation

Mother’s Mobile number

Mother’s Email Id

Annual income of Parents

Local Guardian’s Name

Relationship

Local Guardian’s Address, Contact No & Email ID

Do you have any disability or physical illness? Yes/No. If yes, give details (this information is to serve you better)

• Language Studied in 12th/ PUC

Student Type

Any other Specify

Educational Qualification

Please fill in all the details of your examination even while AWAITING YOUR RESULTS

10th Board / University

10th Institution

10th Grade / Class / Percentage

10th Subject

Upload 10th Marksheet

12th Board / University

12th Institution

12th Grade / Class / Percentage

12th Subject

Upload 12th Marksheet

Languages Opted

Registration Fee: Payment of Rs. 750 ( INDIAN and SAARC nationals only) to be paid through UPI or NEFT . Account Name: SAMPURNA MONTFORT COLLEGE Account Number: 0399053000000292 Bank & Branch: SOUTH INDIAN BANK, INDIRANAGAR BRANCH IFSC CODE: SIBL0000399 UPI ID: sampurnacollege@sib Please mention the Transaction ID after the payment of the registration fee.

I hereby declare that all the information provided in this form are correct to the best of my knowledge. I agree to adhere to the rules and regulations, scheme of studies, examinations, and the attendance requirement of the BNU.I undertake to pay the stipulated fees and other payments for specific activities which form part of the academic requirement.