Application for Admission To II / III Year Diploma Course

The Principal
Navjeevan Education Society's Polytechnic
Bhandup - 4000078

I am desirous of being admitted to II / III year Diploma course. I shall respect and abide the rules
& regulation and tradition & general discipline of the institute. I here by given the following particulars
which are true to my knowledge & belief.

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    First Name *
    Middle *
    Last *
    Adhar No *
    Gr No
    Address *
    Mobile *
    Date of Birth *
    Details of Marks Obtained Last year Examination. *
    * Please do not keep row blank put ' - ' in table .
    Year Exam Summer/Winter Exam Seat No. Marks Obtained Max Marks First/Second/Pass/ATKT
    1st Sem.
    2nd Sem.
    3rd Sem.
    4th Sem.
    DD NO
    Bank Name

    Bring The Xerox Copy Of Given Required Document While Submitting

    • Mark Sheet last year
    • Last year Fees Receipt
    • Allotment letter
    • Aadhar Card
    • Ration Card
    • Undertaking for Ragging
    • Caste Certificate
    • Caste Validity Certificate
    • Non creamy layer Certificate
    • Gap Certificat
    • Last Year Scholarship / Freeship Form zerox
    • Other

    Sign Of Applicant