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GROUP OF INSTITUTIONS
PROVISIONAL ADMISSION FORM (MCA I YR./ MCA Direct II YR.)
(TGPCET)
(TGPCET)
PROVISIONAL ADM. No.Name of Staff:
Name of Candidate:______________________________________________________________________________________ _____________
Father's Name:_______________________________________________ Mother's Name:__________________________________________
Category:___________Caste:__________________ Date of Birth: ________________ Place of Birth: _________________ (Dist:___________)
Communication Addres: At _______________________ Post _______________________ Tah. ___________________ Dist. _______________
Pin Code: ______________________ Father's Occupation: _____________________________ Annual Income: _________________________
th th10 Roll No: ____________________________ 12 Roll No.: _______________________
Mobile Number: (1) ________________________________________________ (2) ________________________________________________
Name & Address of Grad.College: __________________________________________________________Area: _________________________
th thAggr. Percentage in 10 % 12 % Gradu.% Marks Out of
Year of Passing: ( Last Exam.: ____________________________________ Stream: _______________________________________________)
MCA-CET APP.ID.: ___________________________ MCA-CET Roll No.: ____________________ MCA-CET Score:_______________
TF (C) Scholarship Hostel Fees Bus Fees Mess Fees L.M. Remarks
List of Original Documents submitted (Tick Mark on the right)
1 10th Marksheet/Diploma 2 12th Marksheet/Diploma 3 Leaving Certificate (TC)
4 Caste Certificate 5 Caste Validity 6 Non creamy layer Certificate
7 Age / Domicile / Nationality 8 Score Card-MH-CET 9 Proforma - H
10 Bank Pass Book Xerox 11 Gradu. MS ( I , II, III, IV, V, VI Sem.) 12 Income Certificate
13 Adhar Card Xerox
DECLARATION BY STUDENTI hereby declare that with the consent of my parents/guardian,I have willingly taken provisional admission to course offered by Gaikwad-Patil Group of Institutions. I am submitting my original documents to them without any pressure. I have read the instructions of provisional admission and also cancellation of admission. For cancellation of my provisional admission, I will strictly follow the rules of the institute known prior to me. i.e. I) Either i am not eligible II) By paying Rs. 5000/- cancellation charges III) After CAP rounds. Further I state that i will not launch any complaint to any higher authority for issue of admission. If I do so it will be consider as invalid.
Fees Paid: ___________________ Receipt No: _______________ Date: __________
Signature of the Candidate/ Parent Date:_______________ Signature & Name of the Faculty/Counseller
Acknowledgment Slip GAIKWAD-PATIL GROUP OF INSTITUTIONS Date: ______________
Full Name of the student : _____________________________________________________________________________________________
List of Original Documents submitted (Tick Mark on the right)
1 10th Marksheet/Diploma 2 12th Marksheet/Diploma 3 Leaving Certificate (TC)
4 Caste Certificate 5 Caste Validity 6 Non creamy layer Certificate
7 Age / Domicile / Nationality 8 Score Card-MH-CET 9 Proforma - H
10 Bank Pass Book Xerox 11 Gradu. MS ( I , II, III, IV, V, VI Sem.) 12 Income Certificate
13 Adhar Card Xerox
DECLARATION BY STUDENT
I hereby declare that with the consent of my parents/guardian,I have willingly taken provisional admission to course offered by Gaikwad-Patil Group of Institutions. I am submitting my original documents to them without any pressure. I have read the instructions of provisional admission and also cancellation of admission. For cancellation of my provisional admission, I will strictly follow the rules of the institute known prior to me. i.e. I) Either i am not eligible II) By paying Rs. 5000/- cancellation charges III) After CAP rounds. Further I state that i will not launch any complaint to any higher authority for issue of admission. If I do so it will be consider as invalid.
Signature & Name of the Faculty
{ Contact No.:-________________________} Signature & Name of the Candidate/ Parent
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