06.01.2013 Views

admission brochure - Teerthanker Mahaveer University

admission brochure - Teerthanker Mahaveer University

admission brochure - Teerthanker Mahaveer University

SHOW MORE
SHOW LESS

Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

Form No......................................<br />

TeerThanker <strong>Mahaveer</strong> UniversiTy<br />

Delhi Road, Moradabad (U.P.) - 244 001<br />

Application Form<br />

(Session 2012-2013)<br />

1. Program Applied for............................................................................................................................................................<br />

2. Preference for branch/specialization in case of B. Tech. / MBA/ M. Tech/M.Sc. Medical/<br />

M. Sc Home Sc./M. Pharm/M.Sc. Nursing/MDS/MD/Diploma in Engineering programs.<br />

1. 2. 3. 4.<br />

5. 6. 7. 8.<br />

please paste your<br />

recent coloured<br />

passport size<br />

photograph<br />

here<br />

3. Name of the candidate.....................................................................................................................................................<br />

(English) (Hindi)<br />

(in capital letters as per matriculation certificate)<br />

4. Date of Birth............................................................................................................5. Gender (M/F)...............................<br />

6. Father’s Name.......................................................................................................................................................................<br />

(English) (Hindi)<br />

Signature of the Candidate<br />

7. Mother’s Name......................................................................................................................................................................<br />

8. Category (General/OBC/ST/SC/Others).......................................................................................................................<br />

9. Residence Status..................................................................................................10. Blood Group...............................<br />

(Village/Town/City)<br />

11. Parents Occupation: Father............................................................................. Mother..................................................<br />

12. Parents Education: Father................................................................................ Mother...................................................<br />

13. Family Annual Income (Rs.)................................................................................................................................................<br />

14. State of Domicile.................................................................................................. 15. Mother Tongue...........................<br />

16. Religion....................................................................................................................17. Nationality.....................................<br />

1/4

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!