5. GENDER: Male Female 6. CATEGORY Gen ST SC OBC 7. NATIONALITY Indian Others If others, Please specify 11. HOSTEL ACCOMMODATION Yes No 13. CONTACT NUMBERS STD Code Telephone No. Country Code Mobile No 1. NAME OF THE CANDIDATE (as in your high school or equivalent certificate) 2. MOTHER’S NAME (as in your high school or equivalent certificate) 3. FATHER’S NAME (as in your high school or equivalent certificate) APG SHIMLA UNIVERSITY APPLICATION FORM-2013 INSTRUCTIONS 1. Please read the instructions in the Admission prospectus 2013 before filling up this form. 2. Use BLACK BALL POINT PEN in Boxes using English Capital letters or English numerals. 3. Do not make any stray marks on this sheet. 4. Do not staple pin, wrinkle, and scribble, tear, wet or fold this sheet. 5. Write in CAPITAL LETTERS only within the box without touching the lines. 4. PHYSICAL STANDARDS Height jjjjjj Weight ft. inch kg. 8. PROGRAM APPLIED FOR : (1) _________________________ _____________________ (2) ______________________________________________ 9. DATE OF BIRTH Date Month Year 10. PRE QUALIFYING TEST Name of Pre Qualifying Test : Scores Obtained: 12. Write your complete Correspondence address including your name in English in Capital Letters with BLACK Pen (For all communication including letter of admission) Name Address Email Id City State: Pin Write application form number at the back of a recent color photograph (Only on white background) (Size 3.5 and 5 cm) & paste (do not staple) (Within the Box Only) Do Not Attest 14. SIGNATURE OF THE CANDIDATE 15. PHOTOGRAPH Application Form Number19. EMPLOYMENT HISTORY Detail of current /last job Organization Name : Address of Organization City: Tel: Last Designation :____________________________________________ __ 16. EDUCATION QUALIFICATION Year of Passing Board Stream Medium of Examination Total Marks Marks Obtained % of Marks/CGPA DETAILS OF (10+2) 12th / A Level Year of Passing Board Stream Medium of Examination Total Marks Marks Obtained % of Marks/CGPA DETAILS OF GRADUATION Year of Passing Board Stream Medium of Examination Total Marks Marks Obtained % of Marks/CGPA DETAILS OF POST GRADUATION Year of Passing Board Stream Medium of Examination Total Marks Marks Obtained % of Marks/CGPA DETAILS OF DIPLOMA Year of Passing Board Stream Medium of Examination Total Marks Marks Obtained % of Marks/CGPA DETAILS OF OTHER QUALIFYING EXAM Year of Passing Board Stream Medium of Examination Total Marks Marks Obtained % of Marks/CGPA 17. PROFESSIONAL COURSES (Other than Degree) S.No Institution Course Full/Part Time Year Qualification Given 18. AWARDS / ACHIVMENTS (if any) (i) _________________________________________ _ (ii) _______________________________________________________________________________________________ Work Experience? Yes No If "Yes", total years of work Part Time Full Time20. FAMILY INFORMATION Age Qualification Profession Organisation Designation Father Mother 21. EMAIL ADDRESS OF PARENTS: Father Mother 22. DETAILS OF PAYMENT OF FORM 23. SIGNATURE Do you suffer from any chronic ailment? Yes No If yes, give details : Have you ever been suspended, dismissed or put on academic probation or warning at any school or college? Yes No If “Yes”, Please explain on a separate sheet of paper. By CASH Cash Receipt No.:______________________________________________________________________________ ___ By Demand Draft DD No._______________________Bank____________________________________Date : _____________________________ THROUGH ONLINE Online Transfer No:_________________________Receipt No______________________Date: ____________________________ I hereby certify that the information given in the Application (all relevant forms) is complete and accurate. I understand and agree that misrepresentation or omission of tact will justify the denial of admission, the cancellation of admission or expulsion. I have ready and do hereby consent to the Terms and Conditions for admission prospectus 2013. Signature:____________________________ Date:________________________________ Registration fee is Rs. 10,000/- to be made in favor of APG Shimla University. Student who register themselves on or before 30th April 2013 will be getting a discount of 50% in registration fee. Banking Details : APG SHIMLA UNIVERSITY BANK: CANARA BANK A/C NO-1964201000567 IFSC CODE-CNRB0001964 BRANCH – MALL ROAD, SHIMLA Student can also make online payment through our website : apg.edu.inAPPLICATION INSTRUCTIONS PLEASE READ THE INSTRUCTIONS CAREFULLY BEFORE YOU BEGIN TO COMPLETE YOUR APPLICATION. THE APPLICATION FORM SHOULD BE FILLED IN YOUR OWN CLEAR AND LEGIBLE HANDWRITING AND THE UNDERTAKING IS TO BE SIGNED BY YOU ONLY. • Visit apg.edu.in for all information relating to your application & admission after submission of application form • Qualifying candidates can select their date for On Campus Admission Process at apg.edu.in. It is your responsibility to check the website for selection of date and appear in the Admission Process accordingly. No separate communication will be sent in this regard. • You are advised to keep a photocopy of the complete application form. • Incorrectly filled, incomplete, unsigned forms & forms received after due date i.e. 30th June 2013 will be rejected. • Forms once rejected will not be reconsidered & form cost will not be refunded. • You can not apply more than once for the same programme in one admission year. • APG does not take any responsibility for delay or loss of the material in post / transit. Do not attach any Mark sheets / Testimonials with the Application Form at this stage (Only foreign students / Foreign University Degree holder should attach photocopies of academic transcripts & AIU Equivalence Certificate). University / Board / Marks filled in the Application Form will be considered for all procedures related to admission. Any discrepancy found during original document verification will result in cancellation of Admission. We do not accept any donations for admission. Merit is the only criteria. Any instances found, even at a later date, will lead to cancellation of admission. TERMS AND CONDITIONS FOR ADMISSION 1. Non-Liability: Prospectus Application Form and all other Admission Correspondence will be sent by Post/Courier. APG is not responsible for Postal / Courier delays or loss in transit. 2. Non-refund of fees: All fees once paid are not refundable for any reason whatsoever. Only Security Deposit will be refunded after making necessary adjustments as required. 3. Fees 3.1 Cancellation of Admission: APG reserves its right to cancel the admission of successful candidate under any of the following circumstances: (a) If the fees is not deposited by the stipulated date. (b) If the candidate does not join the particular programme by the stipulated date even though the fee has been deposited. (c) If the candidate fails to furnish the proof of the stipulated minimum qualifications. (d) If any instance of donation/unfair means is found after admission. (e) If any of the document(s) submitted by you to APG Shimla University are found to be forged, fabricated or false during the period of your study, your admission shall be cancelled immediately and fees shall be forfeited. In case you complete the course and obtain the degree on the basis of documents which are later found to be forged, fabricated or false, at any point of time, your degree shall be cancelled/ recalled. 3.2 Provision of Non Refund of Fees under Clause 2 will also apply in cases under Clauses 3.1 (b) and (c). 4. Right of Alteration/Modification: (a) APG reserves its right to alter or modify the structure of any of the programs to attain the objective of excellence. (b) APG reserves its right to change the provided Fee Structure. (c) APG reserves its right to modify, alter and/or include any other Terms and Conditions that may be deemed fit in the interest of the Institution. 5. Jurisdiction: Any dispute pertaining to admission, or any matter as a student or alumnus of APG shall be subjected to the jurisdiction of the Shimla,(H.P) Court only. 6. Limitation Clause: No dispute shall be raised after the expiry of 30 days from the date on which the process of admission and/or selection is completed. 7. Agreement Clause: All successful candidates shall be bound by the above mentioned Terms & Conditions of APG. *****
Posted on: Mon, 24 Jun 2013 17:17:12 +0000
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