Pacific Group Of College Admission Form


Course Information
Session *
 
Faculty *
 
Course *
 

Personal Information
Salutation *
 
Name of Candidate *
(in the formate mention in Mark sheet)
 

Father's/Husband's/Guardian's Name *
 
Father's/Husband's/Guardian's Occupation *
 

Mother's Name *
 
Mother's Occuptions

Date of Birth *

 
Marital Status
Single Married

Are You Applying for Hostel
Conveyance Desired

Gender
Male Female
Whether belong to / Social Category *
 

Region *
 
Nationality *
 


Contact Information

Address for Correspondance


Address Line 1 *
 
Address Line 2

City/Town/Village
District *
 

State *

 
Country *
 

Pin/Zip Code *
 

Email *
   
Confirm Email
 

Mobile No. *
 
Alternate Mobile No.

Land Line Number with STD Code

Permanent Address
Tick Check Box for same as Address for Correspondance


Address Line 1
Address Line 2

City/Town/Village
District

State
Country

Pin/Zip Code

Email
 
Confirm Email

Mobile No.
Alternate Mobile No.

Land Line Number with STD Code


Academic Information
Sr. No.
Exam Passed
School/Collage Name
University / Board
Subject
Year of Passing
Max. Marks
Obt. Marks
Percentage / Grade

1
Secondary

2
Sr. Secondary

3
Under Graduate

4
Post Graduate

5
Other

Employment Information (If Employed)
Sr. No.
Organization
Duration
Position Regular/Temporary
Nature of Duties

1

2

3


Upload photo Signature & Signature and Documents
Upload Photograph *
   

Upload Signature *
   


Declaration

I Declare that entries made by me in this Admission form and the document submitted by me with the admission form are true in all respected and in any case, any information is found to be false,this shall entail automatic cancellation of my admission beside rendering me lible to such action, as the University mey deem proper.
I note that my admission to the University and my continuance on it rolls are subject to the provision/rules of the University, issued from time to time.I shall abide by the rules of discipline and proper conduct.I am fully aware of the law regarding as well as the punishment and that if found guilty on this account I am liable to be punished appropriately.
I Declare that I have read the prospectus carefully and understood that the dispute if any will be subject to jurisdiction ,Udaipur,Rajasthan Only.