Admission No :

RAMANUJAN JUNIOR COLLEGE

Arts & Science B.M.Road, Amolapatty, Nagaon

ADMISSION FORM

2018-19

To,

The Principal

Ramanujan Junior College

Course applied for Arts stream : H.S I H.S II

Science stream : H.S.I H.S.II

Medium applied for Arts : Eng As For Science English only

Respected Sir,

I want to take admission in Ramanujan Junior college. I have read the terms and conditions of the

institute mentioned in the prospectus . I agree to abide by the same. My particulars are given below :

(Please fill the form in capital letters with Black Ball pen only,Follow the instructions before filling up the

form.)

Arts : Eng MIL: As Beng Hind Alt.E Edu Posc Logic Eco AdvAs Soc Sans Geo

Hist Anthropology

Science : Eng MIL:As Beng Hind Alt.E Phy Chem Math Biol Stat Computer Science

1.Name in full :

2. Father's Name :

3. Mother's Name :

4. a. Occupation of father : b. Occupation of mother :

5. Date of Birth : 6. Age on 30th April 2018

D D M M Y Y D D M M Y Y

7. Place of Birth : 8. Mother Tongue :

9. Belong to Below Poverty Line : Yes / No 10. Tea Tribes / Ex – Tea Tribes :

11. Annual Family Income Upto 1 Lakh : Yes / No 12. Physical Identification Marks :

13. Student Aadhar Number :

14.Residential Address : Vill/Town____________________________________P.O__________________________

P.S______________________Dist__________________State___________________Block____________________

Habitation _______________________Pincode____________________Phone No___________________________

Mobile No1 2. Email_____________________

15. Address for correspondence : C/o ______________________Vill/Town_____________________________

P.O.___________________P.S_______________Dist____________________State________________

Pincode_________________Phone.No._______________________

Mobile No.1. 2.

16. Address of local guardian : C/o ______________________Vill/Town_____________________

P.O.___________________P.S_______________Dist____________________State________________

Pincode_________________Phone.No._______________________

Mobile No.1. 2.

17. Nationality: Indian Others 18. Sex : Male Female

19. Religion : Hindu Muslim Christian Sikh Jain

20. Category code : Gen SC ST OBC/MOBC

21. Last Examination Passed :

(a) Board : SEBA CBSE ICSE AISSE

(b) Name of the School :

(c) Name of the Exam : (d) Year of Passing : (e) Roll : No :

(f) Registration No. : (g) Total Marks : (h) Marks Obtained :

(i) Percentage : (j) Grade : (k) Subjects :

22. Marks Obtained in last HSLC Examination 20.....

Subject Eng MIL G. Math G.Sc S.S Elective Total % of Marks Division

Obtained

Full Marks

Marks obtained

23. Marks Obtained in last H.S 1st yr (Sc) Examination 20.....

Subject Eng MIL Phy Chem Math Bio Stat CSCA Total % of Marks Grade

Obtained

Full Marks

Marks obtained

24. Marks Obtained in last H.S 1st yr (Arts) Examination 20.....

Subject Eng MIL Pol.Sc Edu Logic Eco Sans Geo Soci Anthro ADAS Math Stat Total % of Marks Grade

Obtained

Full Marks

Marks obtained

25.. Extra curricular activity :

26.(a) Bank A/c No. of Student :

(Nationalised Bank)

(b) Name of Bank

(c) Branch

(d) IFSC CODE

Declaration by the candidate : I hereby declare that the above entries in the application form have been filled up in my own handwriting and

the entries made are correct as per my documents and to the best of my knowledge and belief. If any statement is

proved to be false then the college authority will have the right to take any legal action .

Signature of the Parent/Guardian Signature of the candidate

Place_______________ Place_______________

Date ____________ Date_____________

Admission No. :........................................ Checked & Verified by........................

Date of Admission :.............................. Admission granted / not granted

Roll No :...............................................

Exam Passed :...........................................

Div/Grade :.............................................. Principal

RJC, Nagaon

Encloser :- 1) Attested photocopies of marksheet, pass certificate, admit card, registration certificate, caste certificate,

2) 5 stamped envelope .

3) Character Certificate from the head of the institution last attended.

4) 3 Passport size photograph .

5) PRC Certificate will be enclosed within 6 months .

NB : Prospectus of the College will be collected at the time of submission of forms. Offline form

should be attached with Download form.Form will be rejected without offline from no.

Thumb Impression

Instruction to the Applicant for filling up the form

1. All the guardians are hereby requested to keep in their possesion two filled up xerox copies of the

Admission form as the relevant entries will be needed for applying to procure the PRC from the

District Administration.

2. Fill up the application form with BLACK BALL PEN only.

3. Write name in capital letter leaving one box between first name, middle name & surname.

4. Darken the circle completely like this wherever necessary and not like this.

5. Signature affixed on the Application Form must be in full.

6. Photograph must show the date of photograph taken and name of the applicant.

7. Three extra photographs bearing Application Form No. on the back of the photograph must be

submitted along with filled in Application Form.

8. Affix Signature below the photograph .

9. Put the thumb impression at the space provided for.

10. Donot use eraser either solid or liquid or put any stray marks while filling up the Application Form.

11. Darken the relevent category circle.

(i)Category :

Gen : General SC : Scheduled caste ST : Scheduled tribe OBC/MOBC : Other backward class/

More other backward class

(ii)Subject :

ENGL : English, MASS: Assamese, MBEN: Bengali, MHIN : Hindi, ALTE: Alternative English,

EDUC: Education, POSC: Political Science, LOPH : Logic & Philosophy, ECON: Economics,

ADAS: Advance Assamese, SOCI: Sociology, SANS: Sanskrit, GEOG: Geography, Hist : History

Anthro : Anthropology

PHYS : Physics, CHEM: Chemistry, MATH: Mathematics, BIOL: Biology, STAT: Statistics,

CSCA:Computer Science.