Shri Ram Tirth Chaudhary Mahavidyalaya

Imilia, Banghusra, Utraula, balrampur (U.P.) - 271609

Online Admission Form

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Choose Subject     Hindi English Political Science Education Ancient History Geography Sociology Home Science Urdu
Choose Subject     Zoology Botany Chemistry Physics Mathematics
Choose Subject     Education Sociology Hindi Home Science Political Science
Choose Subject     All Subject
Choose Subject     Home Science
Student Name: Father's Name:
Mother's Name: Category:
Contact No. : Religion:
Other Contact No.: Caste:
Date Of Birth:
YYYY-MM-DD Fill Using Calendar		 Gender:
Permanent Address: Local Address:
Same Address:
State: District:
Staff Dependent: Are you Physically
Handicapped?:
Nationality: Pin Code:
Other Certification: NCC Certificate NSS Certificate Scout Certificate Sport
Adhar card number: Email Id:
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Academic Qualification
Qualification
Board/University
College Name
Pass Year
Type
Roll No.
Total Marks
Obtained Marks
(%)Marks
High School

0
Inter-Mediate

0
Graduation

0
Previous Year Examination

0
I have read & understand all term & condition. If any type of false or mismatch found in my statement and in documents, I will be responsible for that mistake & reject my admission.

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