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VICTORIA COLLEGE OF EDUCATION
72/10, Madhubhan Farm House, Nayapura, Kolar Road, Bhopal
          *Passport size Photo
Application For Admission Session 2014  -  2015
         
  Form No. : 
  *Course : 
  *Year :   
Select appropriate option:      
*Category :
*Medium of instruction :
   
             
Marks obtained in the qualifying examination:      
* Year of passing :
* Class :
     
* Stream :
     
  Year :
  Semester :
* Enrolment No. :
* Roll No. :
* Marks obtained :
* Total Marks :
  Grade :
* Institute :
     
* Board / University :
     
* Enclose Marksheet :
       
Subjects/ Papers taken at Graduate/ Post Graduate level:      
* Compulsory :
  Optional :
  Practical :
  Foundation :
       
*Date of Birth (In Figures) : Click Here To Pick A Date!    Blood Group :
In words :
Age (As on 1 July 2014): Years:    Months:   Days:  
       
1.  Full Name of the Applicant      
  Salutation First Name Middle Name Last Name
*
* Contact No. :  
* Email Address :  
 
   
2.   *Full Name of Father and Occupation :  
      Salutation First Name Middle Name Last Name
  Name :
  Occupation :
     
3.   *Full Name of Mother and Occupation :  
      Salutation First Name Middle Name Last Name
  Name :
  Occupation :
     
4.  Full Name of Husband and Occupation :  
      Salutation First Name Middle Name Last Name
  Name :
  Occupation :
     
5. *Permanent Address :
  Telephone No. :  -
6. *Local Address   Same as above
    :
  Telephone No. :  -
7.   Name, Address and occupation of the local guardian in case parents do not reside with you:
  Name :
  Occupation :
  Address :
  Telephone No. :  -
  Mobile No. :
 
8.   Name of railway station (enclose certificate, permanent address for availing railway concession):
  Address :
  Certificate :
 
9.   *Nationality  :  
10. Place of Birth:
  *Tehsil :
     
  *District :
     
  *State :
     
11. Is the applicant domicile of M.P. : Yes   No      
12. Is there any gap in studies:  
  Years of gap :
13. Is there any legal case/issue pending against the applicant in any court of law / police station / Institution previously studied? If yes tick the box
14. Is applicant in service? If yes tick the box
15. Details of examinations passed: (Fill up entire information)
*(a)Secondary 10th
  Roll Number :
  Enrolment Number :
  Year of passing :
  Grade :
  Marks obtained :
  Total Marks :
  Regular / Private :
  Subjects :
     
  Name of Institute :
     
  Name of Board / University :
     
  Enclose Marksheet :
*(b)Higher Secondary 10+2
  Roll Number :
  Enrolment Number :
  Year of passing :
  Grade :
  Marks obtained :
  Total Marks :
  Regular / Private :
  Subjects :
     
  Name of Institute :
     
  Name of Board / University :
     
  Enclose Marksheet :
(c) Graduation :
(d) Post Graduation :