:: Apply Online Application Form - 2011-12
 

Pt. Ravishankar Shukla University, Raipur (CG)
Application for Admission
Session 2011-12

 
Class *
Unit. Enrolment No Max 50 characters
If Non - Collegiate applicant, then Registration No. Max 50 characters
 

  The Fields Marked as * are Mandatory

 Personal Information :  
  First Name * Middle Name Last Name *
Name of the Applicant * Max 50 characters Max 50 characters * Max 50 characters
Father's Name *Max 50 characters Max 50 characters *Max 50 characters
Mother's Name *Max 50 characters Mac 50 characters *Max 50 characters
Nationality Indian
Religion *
Caste *
Date of Birth (DD/MM/YY) *
Place of Birth * *Max 50 characters
Email Id * *Invalid format.Max 60 characters
 Address (Do Not Repeat Name) :  
Permanent Address  
Street * City * District * State *
*Max 100 char *Max 50 char *Max 50 char *Max 50 char
Pin Phone (with STD Code) Mobile (If Any)  
Invalid formatMin 5 DigitMax 5 Digit Invalid noMax 15 Digit Max 15 charInvalid no  
Local Address  
Street * City * District * State *
*Max 100 char Max 50 char* *Max 50 char *Max 50 char
Pin Phone (with STD Code) Mobile (If Any)  
Invalid format.Max 6 DigitMin 5 Digit Invalid noMax 15 Digit Invalid format.Max 15 Digit  
Category *

Other (Please Specify)   

Max 100 char
 Other Details :  
Sports & Other Activities Max 200 char
Other Details :  
a. Employment (If in service attach no Objection
    Certificate of Employer)
Max 200 char
b. Unfair means in Examination Max 200 char
c. Any case pending with Examination Max 200 char
d. Blood Group
Details of Admission in other courses Max 200 char
Is there any gap between last examination passed and year of admission.
   

 

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