Admission Form - Kamla Lohtia Sanatan Dharam College

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KAMLA LOHTIA S.D.

COLLEGE
SUBHASH NAGAR, DARESI ROAD, LUDHIANA
( Affiliated to Panjab University, Chandigarh )
ESTD. 1992
Session 2024-25
ADMISSION FORM No. Application for admission to B.C.A Semester III
2024-0247

(To be filled in by the office)

Receipt No. Date Roll No.

1. Name (In capital letters) as in Matriculation Certificate : BOBBY


2. Father's Name : SANJEEV VERMA 3. Mother's Name : KUSAM RANI 4. Guardian's Name : SANJEEV VERMA
5. Parent's Occupation : Business 6. Annual Income : 400000 7. Blood Group : O+
8. Date of Birth as in Matriculation Certificate : 14-12-2005 9. Aadhaar Number : 298204790459
10. Category : B.C./O.B.C.
11. Residential Address : H.NO 154, TAJPUR ROAD, GURU NANAK NAGAR, BHAMIAN KALAN, LUDHIANA 141015 Pin Code : 141015

Mobile No. : 6284130510 Mobile No.(Parents) : 6283562425 Email address : [email protected]


12. Subjects Offered : 1. BCA-16-301 PUNJABI-A 2. BCA-16-303 INFORMATION SYSTEM DESIGN AND IMPLEMENTATION 3. BCA-16-304
COMPUTER ORIENTED NUMERICAL METHODS 4. BCA-16-305 DATA STRUCTURES 5. BCA-16-306 LAB BASED ON BCA-16-304 6. BCA-16-307 LAB
BASED ON BCA-16-305
13. Add on Course : 14. Hons. Course (Only for B.Com II & III year) :
15. Registration No./Pupin No.( In case of old student of Panjab University, Chandigarh ) :
16. Academic Record (Attach duly attested copies of certificates)
Marks Obtained % of
Class Roll No Year Subjects University / Board
/ Total Marks Marks
Matriculation 1021565561 2021 570 / 650 87.69% PSEB

Commerce
Economics, Mathematics, Business Studies,
Accountancy, Computer Science/Computer
Senior Secondary 2023178370 2023 339 / 500 67.8% PSEB
Applications/Information
Technology/Informatics Practices (For BCA
SEM 1 admission only)
B.C.A Semester I 23050803 2024 233 / 400 58.25% Pu
B.C.A Semester II 23050803 Compartment Pu
17. Distinction achieved : Academics/ Sports/ Co-curricular activities/ any other activities (attach certificate)
18. Have you ever been disqualified from appearing in Board/Univ. Examination, if yes, mention year :
19. Institution last attended : Shiva Public Sr.Sec.School, Ludhiana Class : +2 Year : 2023 Roll No. : 2023178370
20. In case of student coming from other State/University (attach Migration Certificate).
21. Mode of Conveyance : None
22. Vehicle Registration Number :
23. Is your brother/sister an alumnus of this institution if yes, mention Name : Stream : Year of passing : Mobile Number :

I Undertake that :
1. The particulars given above are true to the best of my knowledge.
2. I have not been admitted to any other affiliated college to the class to which I am seeking admission in this college.
3. I shall not claim any right to admission if my admission is not approved by the college/ University authorities at any stage.
4. I promise to abide by the rules and regulations given in the College Prospectus
5. I shall make full payment of college fees/dues on the dates/days notified by the college authorities/Panjab university Chandigarh failing which my
admission may be cancelled.
6. I shall qualify eligibility criteria laid down by Panjab University, Chandigarh.

Date Place Signature of Parents/Guardian Signature Of Applicant

Check List of Documents

1. Attested Copy of Last Exam 2. Date of Birth Proof 3. Character Certificate


4. 3 Photographs 5. Caste Certificate(if applicable) 6. Migration Certificate
7. Aadhaar Card Copy 8. Driving License copy 9. Any other Certificate

Remarks (If Any) :

Checked and Found Correct Recommended for Admission ADMIT

1.

2. Convenor Principal
Admission Committee Kamla Lohtia S.D. College, Ludhiana
(Full Signatures)
Members
Admission Committee

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