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Admission Open 2024-25
APPLICATION FORM
ACADEMIC YEAR (2024-2025)
Application No:
Your Photo (required)
First Name:
Last Name:
Father's Name:
Mother's Name:
Mobile No:
Email:
CONTACT NUMBER
Father's:
Mother's:
Permanent Address
City:
Pin:
State:
--- Select State---
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chhattisgarh
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Odisha
Punjab
Rajasthan
Sikkim
Tamil Nadu
Telangana
Tripura
Uttar Pradesh
Uttarakhand
West Bengal
Country:
Persent Address
City:
Pin:
State:
--- Select State---
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chhattisgarh
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Odisha
Punjab
Rajasthan
Sikkim
Tamil Nadu
Telangana
Tripura
Uttar Pradesh
Uttarakhand
West Bengal
Country:
PERSONAL PARTICULARS
Date of Birth:
Place of Birth:
Gender:
--- Select Gender---
Male
Female
Transgender
Category:
Aadhar Card No:
Blood Group:
Martial Status:
Mention if any disability:
COURSE APPLIED FOR
Course Name:
ACADEMIC QUALIFICATIONS
Examination
Secondary(10th)
Year (From to)
Name of School
Board/university
Maximum Marks
Percentage of Marks
Sr. Secondary(12th)
Year (From to)
Name of School
Board/university
Maximum Marks
Percentage of Marks
Graduation -
(Mention name of the degree)
(Minimum three years course required)
Examination
Year 1
Year (From to)
Name of School
Board/university
Maximum Marks
Percentage of Marks
Year 2
Year (From to)
Name of School
Board/university
Maximum Marks
Percentage of Marks
Year 3
Year (From to)
Name of School
Board/university
Maximum Marks
Percentage of Marks
Year 4
Year (From to)
Name of School
Board/university
Maximum Marks
Percentage of Marks
Note:
1. In case of grades, Please also mention equivalent percentage and attach copy of document in support of this.
2. Omission of Graduation Details (sl no.8) will render the form invalid and likely to be rejected.
WORK EXPERIENCE (if any)
Name & Address of Organisation
Designation
Period (From to)
Nature of Work
TOTAL EXPERIENCE (IN YEARS)
AWARDS & HONOURS
Academic/Professional Awards/Medals/Prizes/Scholarship/Certificate/ Honours,etc.
Year
Name of the Award
Awarding Institution
Level(International, National, State)
Remarks
OCCUPATION OF RELATION/KIN (In Brief)
Relation
Father
Mother
Education
Occupation
Annual Income
Why ADYPU?
Any Entrance Exam
Appearing
Appeared
if Appeared
Name of Exam
Score of Exam
HOW DID YOU COME TO KNOW ABOUT US?
News Paper
Friends
Website
Others
If others please specify
DECLARATION
I certify that the information given in this application is true to the best of my knowledge. I Understand that withholding information requested in this application or giving false information, whether intention or accidental, may make me ineligible for admission or continuation at Ajeenkya DY Patil University. If accepted for admission and enrolled, I agree to abide to by all the rules Policies regulations and financial terms of ADYPU as outlined through various modes of communication from time to time.
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