Admission No :
RAMANUJAN JUNIOR COLLEGE Arts & Science B.M.Road, Amolapatty, Nagaon
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
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
Arts : Eng MIL: As Beng Hind Alt.E Edu Posc Logic Eco AdvAs Soc Sans Geo
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__________________________
Habitation _______________________Pincode____________________Phone No___________________________
Mobile No1 2. Email_____________________
15. Address for correspondence : C/o ______________________Vill/Town_____________________________
Mobile No.1. 2.
16. Address of local guardian : C/o ______________________Vill/Town_____________________
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
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
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
25.. Extra curricular activity :
26.(a) Bank A/c No. of Student :
(b) Name of Bank
(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
Date ____________ Date_____________
Admission No. :........................................ Checked & Verified by........................
Date of Admission :.............................. Admission granted / not granted
Roll No :...............................................
Exam Passed :...........................................
Div/Grade :.............................................. Principal
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.
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
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.
Gen : General SC : Scheduled caste ST : Scheduled tribe OBC/MOBC : Other backward class/
More other backward class
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,