Kanhaiya Smarak Mahavidyalaya Kushhan Brahaman Ballia

Admission Form - 2017-2018

Application Form

Select Course type UG   PG
Select Subject Applied
Subject Name
Candidate's Name
आवेदक का नाम
Father's Name
पिता का नाम
Mother's Name
माता का नाम
Date of Birth
जन्म तिथि
Mobile Number
मोबाइल नम्बर
Details Of Educational Qualification / शैक्षणिक योग्यता का विवरण
Qualification / उत्तीर्ण परीक्षा Type Board / बोर्ड Roll No. / अनुक्रमांक Passing Year / वर्ष Max Marks / पूर्णांक Marks Obtained / प्राप्तांक
High School High School
Intermediate Subject Group
Graduation Subject
Weightage (Category A) (Optional)
अधिभार श्रेणी A
Weightage (Category B) (Optional)
अधिभार श्रेणी B
Have You Passed Graduation
क्या आप स्नात्तक परीक्षा हैं

Freedom Fighter
स्वतन्त्रता संग्राम सेनानी श्रेणी :
Are you Physically Challenged ?
क्या आप शारीरिक विकलांगता श्रेणी से सम्बन्धित हैं ?

Parent's Domicile
Permanent Address / स्थायी पता
Photo Upload
Signature Upload (Full Signature of Candidate)
Declaration I Agree
I certify that I have filled the form myself and have made all the entries in this form correctly. No request shall be made for any change whatsoever. If any information is found to be false, incorrect or misleading, the college shall have the authority to cancel my candidature / admission without any further enquiry or notice. I undertake that if admitted, I shall abide by the U.G.C. regulations on curbing the menace of Ragging, 2009 ordinances governing the discipline of students of the College/University.