ADMISSION CUM EXAMINATION FORM
ACADEMIC COUNCIL OF HIGHER EDUCATION AN AUTONOMOUS BODY. ISO 9001:2008 CERTIFIED AND GOVT. REGISTERED, MHRD NUMBER 53616/2014 - CO/L, CERTIFICATE REGISTERED UNDER CR ACT 1957 (MHRD) DEPARTMENT OF HIGHER EDUCATION, GOVT. OF INDIA, PLANNING COMMISSION NO. WB/2014/0077185
Website: www.achedu.org , E-mail:
[email protected]
PASTE RECENT
CENTRE NAME:
COLOUR PHOTO. DON’T PIN OR STAPLE
CENTRE CODE:
NORMAL
ENTRY TYPE:
ON DEMAND
( TICK IN THE APPROPRIATE BOX ) (SIGNATURE OF THE CANDIDATE)
(TO BE FILLED FOR THE ON DEMAND CANDIDATE’S ONLY)
I,.......................................................................................................................................................... Son/ Daughter of................................................................................................................................. Certify myself that, I think I am eligible for Secondary / Sr. Secondary examination, but I do not have any certification from any recognised Board. Now a day I think the Secondary / Sr. Secondary examination pass certificate is very essential for me, and I have made myself eligible for appearing the examination. So I want to get a certificate from your board. So please Sir, If you kindly grand my proposal and arrange an examination. of Secondary / Sr. Secondary course, then I will be very glad for your kindness. PLACE : DATE :
…….................................................................. SIGNATURE OF THE APPLICANT
TO BE FILLED IN CAPITAL LETTERS ONLY: 1. COURSE DETAILS :
COURSE:
SESSION:
SUBJECT 1:
SUBJECT 5:
SUBJECT 2:
SUBJECT 6:
SUBJECT 3.
SUBJECT 7:
SUBJECT 4:
SUBJECT 8:
2. NAME OF THE STUDENT: 3. FATHER’S NAME:
REG. NO:
4. MOTHER/GUARDIAN’S NAME: 5. CORRESPONDENCE ADDRESS:
STATE
PIN MOBILE
6. DATE OF BIRTH: D
7. GENDER:
D
M
M
Y
Y
Y
Y
MALE / FEMALE :
8. CATEGORY:
GENERAL
SC
ST
OBC
OTHERS
9. NATIONALITY: 10. EDUCATIONAL QUALIFICATION: SL. NO. 1.
NAME OF EXAMINATION
NAME OF BOARD
YEAR
TOTAL MARKS
MARKS OBTAINED
2.
INSTRUCTIONS 1. Admission form without complete information will be summarily rejected. 2. Application received after the last date will not be entertained. 3. Suppression or furnishing any false information by a candidate will lead to cancel his/her admission with out refund of fees. 4. Admission fees will not be refunded under any circumstances. 5. Jurisdiction of any dispute will be Jharkhand. DECLERATION BY THE APPLICANT I have read and understood the rules and regulations of the Board and satisfied myself regarding the eligibility criteria of the board. I have submitted correct information / documents. I shall submit any other document if needed. I understand that my candidature will be cancelled by ACADEMIC COUNCIL OF HIGHER EDUCATION if the information / documents submitted herewith is found wrong or misleading. The institution has full authority to take appropriate action which shall be acceptable to me. The board has the authority to cancel the Degree of the student if any information submitted is found incorrect. The running course is for knowledge and wisdom and not guaranteed for further educational use and job and the course for self help and self employment only. Hence I am taking admission after knowing all legal facts and own choice and without any pressure and I never be entitled to claim any way on any ground of recognition and legal status of the board/organization.
DATE PLACE
: :
............................................................................. (SIGNATURE OF THE CANDIDATE IN FULL)
RECOMMENDATION LETTER FOR CENTRE Certified that the documents produced by the student are verified and stamped by the undersigned and are correct. The candidate has signed the application cum examination form in the presence of mine.
Date: Place:
..................................................................... (Signature of the centre head with seal)