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CORDIA GROUP OF INSTITUTES
                                        SANGHOL, DISTT. FATEHGARH SAHIB

                                       Application Form for Session __________
                       (TO BE FILLED BY THE CANDIDATE CAREFULLY IN BLOCK LETTERS ONLY)


College Name : ______________________________________________________
Course Opted :______________________________ Semester :________________                                      Photo


Entrance Test Roll No. ________________________________________________________
Marks ______________________________ Rank__________________________________




1.       Name_________________________________________________________________________________
2.       Father’s Name ___________________________________ Occupation_____________________________
3.       Mother’s Name __________________________________Occupation_____________________________
4.       Annual income from all sources ___________________________________________________________
5.       Date of Birth __________________________________________________________________________
         (As per Matriculation Certificate)
6.       Are you a domicile of the State of Punjab      Yes/No _______________________________________
7.       Permanent Address ______________________________________________________________________
         ______________________________________________________________________________________
         Phone No. __________________________________ Email _____________________________________
8.       Correspondence Address ________________________________________________________________
         _____________________________________________________________________________________
         Phone No. __________________________________ Email ____________________________________
9.       Academic Qualifications
     Examination         Institute        Board/      Year of        Roll   Max.    Marks      % of    Subjects
     Passed                               Uni.        Passing        No.    Marks   Obtained   Marks
     Matriculation

     Sr. Sec.

     Graduation

     Post-Graduation


     Any other Class




10. Subjects:
     1                                                          6

     2                                                          7

     3                                                          8

     4                                                          9

     5                                                          10
I am seeking this admission purely on my own risk and responsibility. Any misinformation, wrong statement
and discrepancy detected at any stage would automatically result in the cancellation of my admission without
any notice.

I give an undertaking that I agree to abide by the rules and regulations of the institution and understand that the
misbehaviour of any kind with any student or any member of the staff or institution administration will lead to
disciplinary action and even to the cancellation of my admission.

I will not participate in any type of ragging. I will be liable for disciplinary action/legal proceedings/expulsion
from the institution if found guilty inside or outside the premises of the Institutes.

I certify that I am applying with the permission of my parent/ guardian/ husband.

I solemnly declare that the facts stated above are correct to the best of my knowledge and belief.




      Date:                                                                           Signature of Candidate


I promise that my daughter /ward named above will not take part in any activity prejudicial to the interests of the
institute and state. I further certify that I am in a position to pay his/ her institute dues regularly.




                                                                                  Signature of Father/Guardian


                                            FOR OFICE USE
      1.   Category of admission_________________
      2.   Total marks__________________________
      3.   Certificates required (in any)
           Received payment
           Receipt No_______________________Dated_______________________



                                                                                                           Admit
       Clerk                                      Convenor (Admissions)                                  Director


                              ATTACH THE FOLLOWING CERTIFICATES

 1.    The Photostat Copy of marks sheets of matriculation, 10+2, Graduation, Post-Graduation etc. and an
       attested photograph.
 2.    Character certificate issued by the Head of the institution last attended.
 3.    Certificate of merit for the meritorious performance in games or co-curricular activities.
 4.    University entrance test result and admit card.
 5.    Migration Certificate (in original) in case of candidate from other universities.
 6.    Certificate of Reserved Category claimed from competent authority.
 7.    Punjab Residence/ Domicile Certificate.

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Admission 2012 now open

  • 1. CORDIA GROUP OF INSTITUTES SANGHOL, DISTT. FATEHGARH SAHIB Application Form for Session __________ (TO BE FILLED BY THE CANDIDATE CAREFULLY IN BLOCK LETTERS ONLY) College Name : ______________________________________________________ Course Opted :______________________________ Semester :________________ Photo Entrance Test Roll No. ________________________________________________________ Marks ______________________________ Rank__________________________________ 1. Name_________________________________________________________________________________ 2. Father’s Name ___________________________________ Occupation_____________________________ 3. Mother’s Name __________________________________Occupation_____________________________ 4. Annual income from all sources ___________________________________________________________ 5. Date of Birth __________________________________________________________________________ (As per Matriculation Certificate) 6. Are you a domicile of the State of Punjab Yes/No _______________________________________ 7. Permanent Address ______________________________________________________________________ ______________________________________________________________________________________ Phone No. __________________________________ Email _____________________________________ 8. Correspondence Address ________________________________________________________________ _____________________________________________________________________________________ Phone No. __________________________________ Email ____________________________________ 9. Academic Qualifications Examination Institute Board/ Year of Roll Max. Marks % of Subjects Passed Uni. Passing No. Marks Obtained Marks Matriculation Sr. Sec. Graduation Post-Graduation Any other Class 10. Subjects: 1 6 2 7 3 8 4 9 5 10
  • 2. I am seeking this admission purely on my own risk and responsibility. Any misinformation, wrong statement and discrepancy detected at any stage would automatically result in the cancellation of my admission without any notice. I give an undertaking that I agree to abide by the rules and regulations of the institution and understand that the misbehaviour of any kind with any student or any member of the staff or institution administration will lead to disciplinary action and even to the cancellation of my admission. I will not participate in any type of ragging. I will be liable for disciplinary action/legal proceedings/expulsion from the institution if found guilty inside or outside the premises of the Institutes. I certify that I am applying with the permission of my parent/ guardian/ husband. I solemnly declare that the facts stated above are correct to the best of my knowledge and belief. Date: Signature of Candidate I promise that my daughter /ward named above will not take part in any activity prejudicial to the interests of the institute and state. I further certify that I am in a position to pay his/ her institute dues regularly. Signature of Father/Guardian FOR OFICE USE 1. Category of admission_________________ 2. Total marks__________________________ 3. Certificates required (in any) Received payment Receipt No_______________________Dated_______________________ Admit Clerk Convenor (Admissions) Director ATTACH THE FOLLOWING CERTIFICATES 1. The Photostat Copy of marks sheets of matriculation, 10+2, Graduation, Post-Graduation etc. and an attested photograph. 2. Character certificate issued by the Head of the institution last attended. 3. Certificate of merit for the meritorious performance in games or co-curricular activities. 4. University entrance test result and admit card. 5. Migration Certificate (in original) in case of candidate from other universities. 6. Certificate of Reserved Category claimed from competent authority. 7. Punjab Residence/ Domicile Certificate.