D.A.V.

College, Chandigarh
Application Form for Admission
2009-2010
For Office Use Only Sr. No. ........................

Application Form
Class ................................................... Section ................................ Roll No. ............................
Received on .............................
Signature of Receiver ............... Amount received : Rs. ............................... Receipt No. .............................. Dated ................................

Class/Programme you wish to join : ......................................................................................................................................................

Result of Previous Year: Pass/Fail/Compartment ...........................................................................................................................................
Category/Categories against which application is being submitted (Put ü
mark in the relevant box)
For admission to MSc-I in Chem/Zoo/Bioinf/Biotech/MBE
General Defence Personnel quota
Scheduled Caste Terrorist Victims Whether appeared in O-CET conducted
PASTE YOUR
Scheduled Tribe Freedom Fighters by P.U. üthe right box Yes No
Sports Persons Kashmiri Migrants PHOTO HERE
*Physically Handi- Foreign National DO NOT
capped/VH/blind NRI/NRI Sponsored If Yes, marks obtained __________ Rank __________ STAPLE
Widows/Divorced Industry Sponsored
Women 50% of the marks obt. in O-CET __________________
50% of the marks obt. in BSc/BA/BCom ____________

Panjab University Registration Number (if any) U.T. Pool

General Pool
Panjab University PUPIN (10 digit identification Number, if any) Are you claiming
any weightage : Yes/No
1. Name of the applicant (in block letters) : (As in tenth class certificate) (Leave one blank space between parts of Name)

2. (a) Father's Name (in block letters) (As in tenth class certificate)

Occupation : ________________________________ Position/Designation _____________________ Office Address _______________________

___________________________________________ Phone No. _________________________ Mobile No. ______________________________

(b) Mother's Name (in block letters) (As in tenth class certificate)

Occupation : ________________________________ Position/Designation _____________________ Office Address _______________________

___________________________________________ Phone No. _________________________ Mobile No. ______________________________
(c) Guardian's name (if applicable) :

Occupation : ________________________________ Position/Designation _____________________ Office Address _______________________

___________________________________________ Phone No. _________________________ Mobile No. ______________________________

3. Annual Income From all sources Rs.

(For availing half fee concession admissible to students whose parents' income is not more than Rs. 1,00,000 p.a. attach documentary proof.)

4. Date of Birth : 5. (a) Sex (M/F) 5 .(b) Blood Group

6. Birth Particulars :(i) Place __________________ (ii) District ______________________

(iii) State _________________ (iv) Nationality ___________________

7. Full address for correspondence : _______________________________________________________________________________________

_______________________________________________________________________________________
Telephone No. ___________________________ Pin Code : _____________________ E-mail Address ___________________________________

8. Permanent Home Address : ________________________________________________________________________________________

________________________________________________________________________________________
Telephone No. ___________________________ Pin Code : _____________________ E-mail Address ___________________________________

9. Subjects/options you want to study (Please refer to Prospectus.)

(i) _________________ (ii) _________________ (iii) ___________________ (iv)____________________ For B.A./B.Sc.
Subject combination
(v)_________________ (vi)_________________ (vii) ___________________
no. as given in the college
(viii) ________________(ix)__________________(x) ___________________ prospectus

10. Subjects of Hons. you wish to opt for (for B.A. / B.Com. students) _________________________________

11. Previous class details : Session ________________ Class _____________ Roll No. ___________________
(For old students of the College)

12. Have you passed in English in class XII exam ? Yes/No

13. Add-on subject you wish to study (for under graduate students only) ______________________
(Certificate/Diploma Level)

* State whether you would require a writer during exams because of your physical handicap. Yes/No
14. (I) Are you claiming weightage on any of the following grounds? Yes/No

If yes, tick the appropriate box and attach copies of appropriate certificates
(a) Co-curricular Activities :

(i) N.S.S. (ii) N.C.C.

(iii) Cultural Activities (Music, Debate, etc.)

(iv) Youth Welfare (Trekking, Hiking, etc.)
(b) Did you pass your last examination from the Panjab University? Yes/No

(II) (a) Did you participate in Debate/Declamation Contests, etc. during the last three years? Yes/No
(b) If the reply to (a) is Yes, then please give name of contest & its level :
College/University/State/ National ......................................................
Prize won - 1st/2nd/3rd ......................................................

15. Mention gap years, if any. (Furnish affidavit explaining gap) ________________________________________________________________

16. Have you ever been punished for misbehaviour or for using unfair means? If Yes, give details. ____________________________________
_______________________________________________________________________________________________________________

17. Have you ever been disqualified by any Board / University? If Yes, give details. __________________________________________________
_____________________________________________________________________________________________________________
(No candidate is admitted under any circumstances during disqualification period)

18. Are you migrating from another college / University? If Yes, give details. _______________________________________________________
__________________________________________ Migration Certificate attached? Yes/No

19. Do you suffer from any serious ailment? If so give details including details of treatment. ___________________________________________
_______________________________________________________________________________________________________________

20. For Foreign Students Only (Attach photostat copy of passport, duly attested and Eligibility Certificate from Panjab University)
(a) Nationality ___________________________________________ (b) Passport No. __________________________________________
(c) Visa valid upto _______________________________________ (d) Resident Permit ________________________________________

21. Result of Previous Class. Pass/Fail/Compt.

22. Compartment in the subject of _____________________________________________________

DECLARATION BY THE APPLICANT AND THE PARENTS/GUARDIAN

1. I declare that I have carefully read the instructions and state that the entries made by me in this form are correct to the best of my knowledge
and nothing has been concealed. I understand that my admission is liable to be cancelled if any of the statements made by me is found
incorrect.
2. I undertake to observe proper standards of academic conduct and not to associate with any activity that goes against the discipline of the
College.
3. I shall abide by the rules and regulations of the College and the Panjab University.
4. I shall faithfully carry out the instructions issued by the College authorities from time to time.
5. I hold myself responsible for due and prompt payment of fees and all other dues.
6. I understand that I cannot concurrently be enrolled for more than one full-time course of studies.
7. I am fully aware that ragging is strictly prohibited in the College/University. If I am found guilty of indulging in or abetting ragging, I shall be
liable for punishment and expulsion from the Hostel/College.
8. I solemnly state that I am not facing any disciplinary proceedings and have not been disqualified by any Board/University.
9. I have not so far been admitted to any affiliated College/Dept. of the Panjab University in the class to which I am seeking admission.
10. I shall not smoke in and around the College.
11. I shall not use mobile phone in the College.
12. I shall fulfil the requirements of the Panjab University i.e. is 75% attendance of the lectures and 25% marks in House tests.
13. I solemnly declare that the certificates submitted by me along with this application are true and have not been tampered with. I understand
that my admission is liable to be cancelled if any of the certificates is found to be false.

............................................................
Date ............................ (Full Signature of the Candidate)
 I certify that my son/daughter/ward is making this application with my permission. I hold myself responsible for his/her good conduct and
behaviour as a student of the College and for payment all his/her dues during his/her stay in the College. I undertake responsibility that my
son/daughter/ward will attend the classes regularly and punctually to complete the required percentage of attendance as per the Panjab University
rules, failing which I understand that he/she will be rendered ineligible for the final examinations.

............................................................
Date ........................... (Full Signature of the Parent/Guardian)

Name ..................................................................

Address ...............................................................

...........................................................................

...........................................................................

Note : Incomplete application or with wrong/deliberately concealed information is liable to be straightaway rejected.

INSTRUCTIONS FOR CANDIDATES

1. This form must be filled by the candidate in his or her own hand in a clear and legible manner.
2. This application form complete in all respects must be submitted to the College office as has been indicated in the Admission Notice as well as in
the Prospectus on or before the last date indicated, even if the result of the qualifying examination has not been declared.
3. The application form must be completed in all respects. No column should be left unfilled. If any Information sought is not applicable to the
candidate the word "NA'' should be entered against this column. If a candidate omits/conceals relevant information or gives false information,
his/her admission is liable to be cancelled.
4. Attested copies of Board/University Certificates, Certificates claiming special status, etc. must be attached to this application form. In case the
required documents are not attached, the application is liable to be rejected as incomplete.
5. The declaration to be made by the candidate and his/her parent/guardian on page 3 should be signed and dated before the application is
submitted.
6. All certificates/documents submitted by the candidate with this form must be signed by the candidate himself/herself also.

Note : THE CANDIDATES SHOULD UNDERSTAND THAT THE ADMISSION IF GRANTED BY THE COLLEGE WOULD BE PROVISIONAL AND SUBJECT
TO CONFIRMATION BY THE UNIVERSITY.

DOCUMENTS TO BE SUBMITTED WITH APPLICATION FORM

1. Attested copies of Board or University Certificates showing the date of birth and details of previous examinations passed and detailed marks
certificates. (Original Detailed Marks Certificate issued by the University or the Board should be produced at the time of interview.)
2. An attested copy of the certificate of good conduct from the Head of the Institution last attended.
3. Three copies of recent passport size photograph. (One pasted, two stapled).
4. The students will have to submit a personal affidavit about their marks to the college in case their result gazettes are not available with the
college.
5. Original Migration Certificate in case of candidates seeking admission to the college from Universities/Boards/Councils/Bodies other than
Panjab University. Migration Certificate can be submitted latest before 20th September, 2007 because it must reach the University Office by
30th September. Candidate seeking admission to Diploma/Certificate courses will submit 'No Objection Certificate' from the parent
University/Institution in place of Migration Certificate.
6. Certificates relevant to claim any reserved category status.
7. Affidavit explaining gap year/years, if any.
8. Certificates in support of claim for weightage/weightages.
9. Eligibility certificate.
10. Foreign students are admitted if they have eligibility certificate from Panjab University and a long term visa.
11. Bank Draft of Rs.400/- made in favour of Principal, DAV College, Sector-10, Chandigarh payable at Chandigarh.
12. For obtaining the Application Form / Prospectus through post send Bank Draft of Rs.450/-
 ACADEMIC RECORD

Details of Marks

Total marks obtained

Percentage of Marks
School/College from

Pass/Fail/Compt.

Marks obtained out

out of Max. Marks

Marks obtained
which appeared
Name of

Percentage of
Session

Division

of Max. Marks
University/
Examination
Board and Subjects
Roll No.

Matric / Class X

XII Class Exam.

under 10+2 or
its equivalent

B.A./B.Sc./B.Com./
BBA/BCA Part-I

B.A./B.Sc./B.Com./
BBA/BCA Part-II

B.A./B.Sc./B.Com./
BBA/BCA Part-III

B.A. (Hons.)
B.Sc. (Hons.)
B.Sc. (Hons. School)
B.Com. (Hons.)

MCom/MBE 1st Sem

2nd Sem

3rd Sem

M.A./M.Sc. Part-I

Any other Exam.

Signature of the Applicant

Admission Remarks

Percentage in the previous exam :

Deficient in the subject of :
Documents required :

Prof. in-charge Dean Admission Principal

 ACKNOWLEDGEMENT

Application form Serial No. ......................................................

Received from ...............................................................................................................................

application form for class/programme ..............................................................................................

.......................................................................................................................................

Receipt No. ..........................................

Dated .................................................

Signature
 (
To be submitted along with Admission Form
by students already registered with Panjab University, Chandigarh)

DAV COLLEGE, CHANDIGARH College Roll No. ____________

(PANJAB UNIVERSITY ANNUAL EXAM. APRIL 2010) (for office use)
(Subject to final confirmation of eligibility of candidate)
Class: _______________________________________________
Subjects : ____________________________________________
__________________________________________

PUPIN No.
Name : ______________________________________________
Father’s Name : _______________________________________
Mother’s Name : _______________________________________
Centre of Exam : Chandigarh
Centre No. (For office use only : _______________________ (Full Signature of Candidate)

Controller of Examinations Principal

Note: This card must be shown to the invigilating staff with PUPIN Card at P.U. Exam. For April, 2010 Examination.