Form No
Date of Receipt
Previous
Final
M.Sc. (Mathematics)
Self Attested
Photo
Department of Mathematics
Form Fee 100/- (Payable in cash/DD) (Form can be downloaded from college website, the DD
should be in favour of ‘Principal, Engineering College, Bikaner’ payable at Bikaner)
Detail of D.D. No.….……………………….Dated…...……………… Bank Name……………………..
To
Principal
Govt. Engineering College, Bikaner
Student Signature
Sir,
I ……………………………….………… S/o / D/o …………...………….……….……… submitting an application for seeking
admission in the M.Sc. (Mathematics) Course conducted by Mathematics department of your college. Following details are
being supplied to you for your kind persual.
STUDENT PROFILE
To be filled in capital letters only.
1. NAME
2. FATHER’S NAME {do not write Mr./Sh. etc before name}
3. MOTHER’S NAME {do not write Mrs./Smt. etc before name}
4. NAME OF GUARDIAN (In absence of Father and Mother)
5. RELATION WITH APPLICANT
6. FATHER’S OCCUPATION
8. DATE OF BIRTH
DD
MM
9. SEX
YY
11. ADDRESS (Current)
7. Whether he/she is tax payee (Yes/No)
Male
10. CATEGORY
GEN
Female
{ Mark √ sign at appropriate box not }
SC
ST
OBC
PH
{ Please do not repeat parents name }
City/Village
Pin
12. ADDRESS (Permanent)
City/Village
Pin
13. CONTACT NUMBERS
District
{ Please do not repeat parents name }
District
{With STD code}
14. AADHAR CARD NO. (if any)
MOBILE NO. (Self
15.
Alternate contact number
{ Father / Mother }
Email Address (if any)
16. Any other reservation ………………….. (Please provide relevant certificate)
17. RESULT OF QUALIFYING EXAM. .…………… (Pass/Supplementary/Result awaited/Others)
Date:
OTHERS
Signature of Applicant
18. EDUCATIONAL QUALIFICATION
STANDARD
YEAR
BOARD/UNIV.
REGULAR
/ PRIVATE
OPTIONAL
SUBJECTS
Marks in
Mathematics
Total
Obtained
Total
marks
Obtained
marks
%
10th
12th
B. Sc. Part - I
B. Sc. Part – II
B. Sc. Part - III
Note: If there is semester scheme then provide detail of all semesters.
19. Information of earlier enrollment of the candidate (If applicable)
Student Registration no…………………… Course ……………….
University enrollment no. …………….
20. List of certificates/ documents to be submitted by candidate (Self attested/attested by Gazetted officer)
S. No.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Document
10th
Marksheet
Marksheet
Domicile Certificate
Character Certificate
B.Sc. Part-I Marksheet
B.Sc. Part-II Marksheet
B.Sc. Part-III Marksheet
All 6 semesters of B.Sc. (PCM/CBZ/CBG)
(semester scheme)
SC/ST/OBC/SBC/PH Certificate
Kashmiri Migrant
12th
Attestation (defined self attested or by
G officer or original Copy )
Enclosure No.
Self attested
Self attested
Original
Original
Self attested
Self attested
Self attested
Self attested
Self attested
(for benefit in this category) Self
attested
G. Officer
(for benefit of bonus marks)
Certificate in relevance to bonus marks [NSS,
NCC, Scout/Guide, Rover/Ranger, Sports,
Curricular activities, Ex-Serviceman, any other
certificate ]
Total no. of enclosures ……………………………….…………………….. (in words…………………………………………………..)
21. PLEASE FILL THE FOLLOWING COLUMN
S.NO.
Particulars
1.
Do you require hostel of the college
2.
Have you been punished before it
3.
Have you been restricted for the examination
4.
Have you been declared physical handicapped / blind / physically disable etc. 
5.
Do you require college transportation
Please enclose the concerned document.
Date:
Yes / No.
Signature of Applicant
Page 2 of 4
22.
DECLARATION BY APPLICANT:
I …………………………. S/o / D/o …………………………………. declare that I have read all the rules and regulation of the college and they will be followed by me. Also, I will not
cause any damage to college property.
(ii)
I have not been involved in ragging and also will not be involved in such kind of criminal activities. My
candidateship may be cancelled in case of any involvement.
(iii)
Any kind of criminal offence has not been registered against me in the court.
(iv)
I will secure the minimum attendance prescribed by the Maharaja Ganga Singh University, Bikaner for
M.Sc. (Mathematics).
(v)
During the session I will not be employed in any kind of Govt./Private or autonomous body.
(vi)
All the rules and regulation prescribed by the Maharaja Ganga Singh University, Bikaner for M.Sc.
(Mathematics) course is expected to be followed by me.
(vii)
I will not study in any other college parallel to this course.
(viii) The documents/Certificates provided by me with this application form is authentic and in case of any
misinformation my candidateship may be cancelled.
(i)
Date ……../……./…………..
Place …………………………
(Signature of Applicant)
23. Whether you want to participate in any of the following activities in the college.
(a) NCC
[
]
(b) NSS
[
]
(c) Sports/Others
[
]
Receipt of Application Form
1. Name of Course /Class ………………………………………………………………………
2. Name of Candidate ……………………………. Father’s Name ………………
3. Academic Session ………… S.No. …………………… Date ……………….
4. Received by ……….
Page 3 of 4
Recommendation for Admission
1. Applicant’s Name …………………………… 2. Father’s Name…………………………………..
2. Applied Course/Class ………………………………………………………………………………
FOR OFFICE USE ONLY
Serial No……………………………. Date of Submission ……………………. Received by ………………………………
To be filled by admission committee
Mr./Miss……………………………………..has submitted an application for seeking admission in M.Sc. (Mathematics) Course-2017-18
S.No.
Details of Marks/Percentage of
1.
Secondary Exam.
2.
Sr. Secondary Exam.
3.
Graduation for admission in M.Sc.
Mathematics (Previous)
4.
Marks obtained in B.Sc. Part-I
5.
Marks obtained in B.Sc. Part-II
6.
Marks obtained in B.Sc. Part-III
7.
All 6 semesters (Semester scheme)
8.
Marks/percentage to be added
according to admission policy (+)
9.
Marks/percentage to be deducted
acc. to admission policy (-)
10.
Bonus
Total Marks
Obtained Marks
% age
In Mathematics
Total Marks
Marks obtained
Total
To be filled by admission committee & Principal
1.
Applicant is selected for admission
Merit No. …………………………………………..
Admission is granted
Provisional admission is provided
Coordinator
admission committee
Principal
Govt. Engineering College, Bikaner
Category ……………………………………….……
2.
Applicant is not selected due to
………………….……………………………………
Member
Admission Committee
For Account Section
Date of Receipt ……………………..
D.D. Detail
Cash (please submit the bank receipt)
Challan No. ………………………………………..
DD No. :
Bank :
Received by
Auth. Signature
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