M.Sc. (Ag.) Admission Form, 2014

Transkript

1 Select the subject - Horticulture Agriculture Extension (preferred by I & II) M.Sc. (Ag.) Admission Form, 2014 Last date for submission of Application Form Without late fee: 20/07/2014 With late fee (Rs. 200/-): 30/07/2014 Cost of Application Form Rs. 20/- Application Fee (Draft) Rs. 1000/- 1. APPLICANT'S NAME (according to the High school certificate) - (i) IN HINDI... attested by the Principal of College last attended 2. FATHER'S NAME (according to the High school certificate) - (i) IN HINDI MOTHER'S NAME (according to the High school certificate) - (i) IN HINDI DATE OF BIRTH - DAY MONTH YEAR 5. SEX - MALE FEMALE 6. CATEGORY (Please tick ( ) in the box) (i) GEN (ii) OBC (iii) SC (iv) ST (v) College Employee 7. QUALIFYING EXAMINATION (Please tick ( ) in the box) (i) Appearing (ii) Passed

2 8. ARE YOU SPORT PERSON? YES NO IF YES WHETHER (i) District Level (ii) State Level 9. DETAILS OF BANK DRAFT (i) Draft No (ii) Issue Date -...(iii) Amount Rs (iv) Name & Branch of the Bank ADDRESS Mailing Address - Permanent Address - PIN CODE... Mobile No.... PIN CODE... Mobile No DECLARATION I... hereby declare that all the particulars stated above have been filled in by me in my handwriting and true to the best of my knowledge and belief and no fact has been suppressed/distorted. I have read the instructions and I shall abide by the terms and conditions there in. In case any information furnished by me is found wrong at any stage my candidature for the entrance test be cancelled outright without giving me any opportunity and further disciplinary action be also taken against me including cancellation of admission/degree acquired. Further, if admitted I promise to abide by the rules and norms of discipline of the college I join. Signature of Candidate Date : Place : Signature of Father/Guardian CERTIFICATE IN RESPECT OF SON/DAUGHTER/SPOUSE OF THE EMPLOYEE (of C.B. Gupta Agriculture P.G.College, B.K.T., Lucknow) I... hereby certify that Sri/Smt.. mother/husband/wife of Sri/Km./Smt. who has applied for the admission to an M.Sc.(Ag.) programme through Entrance Exam 2014 holds the regular post of... in this College. Date : / / 2014 Signature with seal of the Principal - 2 -

3 M. S c. ( A g. ) A d m i s s i o n F o r m, Admit Card (Filled by office) Roll No:... Date: Examination Center: CHANDRA BHANU GUPTA AGRICULTURE P.G. COLLEGE Time: (Filled by Student) Name :... Father's Name :... Mother's Name :... attested by the Principal of College last attended Exam Co-ordinator M. S c. ( A g. ) A d m i s s i o n F o r m, Verification Card Roll No:... (Filled by Student) Name :... Father's Name :... Mother's Name :... attested by the Principal of College last attended Student's Signature Invigilator's Signature - 3 -

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5 12- ekuuh; lokszpp U;k;ky; ds funsz'kksa dk ikyu djrs gq, egkfo ky; esa jsafxax iw.kzr;% gsa izosf'kr Nk=ksa,oa muds vfhkhkkodksa dks mdr lecu/k esa gesa fu/kkzfjr izk:i ij 'kifk i= izlrqr djuk vfuok;z gksxka 13- ikb~;dze esa lhvsa de dk vf/kdkj fo'ofo ky; ds ikl lqjf{kr gsa 14- izos'k ijh{kk lecu/kh vfhkys[k dk;kzy; esa dsoy N% ekg ds fy, lqjf{kr j[kk tk;sxka 15- ijh{kk d{k esa eksckbyqksu] dsydqysvj vkfn ys tkuk gsa 16- vkosnu&i= ds lkfk izos'k ijh{kk 'kqyd :0 dk jk"vªh;d`r csad ls tkjh csadmªk V tks "Principal, Chandra Bhanu Gupta Krishi Mahavidyalaya, Bakshi ka Talab, Lucknow" ds uke ns; gks] layxu djsaa fcuk izos'k ijh{kk 'kqyd ds vkosnu&i= fujlr dj fn;k tk;sxka 'kqyd dsoy csad Mªk V ds :i esa gh Lohdkj gksxk] udn ;k psd }kjk Hkqxrku eku; ugha gksxka 17- izos'k ijh{kk vkosnu&i= fcuk foyec 'kqyd ds fnukwad 20&07&2014 rfkk :0 200@& foyec 'kqyd ds lkfk fnukwad 30&07&2014 rd egkfo ky; dks izkir gks tkuk pkfg,a fu/kkzfjr frffk ds ckn izkir gksus okys vkosnu&i=ksa ij fopkj ugha fd;k tk;sxka 18- vkosnu&i= ds lkfk gkbzldwy] b.vjehfm,v vadi= o izek.ki=,oa ch0,l&lh0¼d`f"k@m ku fokku½ vfure lseslvj dk vadi= layxu djsaa 19- vu; finm+koxz@vuq-tk-@vuq-t-tk-@vu; osvst dk ykhk ysus okys Nk= l{ke vf/kdkjh }kjk tkjh izek.ki= layxu djsaa 20- dei;wvj [kkuksa esa gkbzldwy çek.ki= ds vuqlkj ekrk o firk ds uke ls igys Jherh@Jh dk iz;ksx u djsa rfkk,d [kkus esa dsoy,d gh v{kj dk iz;ksx djasa tsls%& V I K A S K U M A R S I N G H 21- izos'k ijh{kk,oa izos'k ls lecfu/kr lelr lwpuk;sa egkfo ky; ds uksfvl cksmz ij rfkk egkfo ky; dh osclkbv ij miyc/k jgasxha Nk= izos'k QkeZ ij viuk eksckby ua0 Li"V vafdr djsa] ftlls vko';drk im+us ij eksckby Qksu ls Hkh lwfpr fd;k tk ldsa - 5 -