M.Sc.(Ag)Entrance-2015 - the website of Chandra Bhanu Gupt
Serial No.:
CHANDRA BHANU GUPTA AGRICALTURE P.G. COLLEGE
BAKSHI KA TALAB, LUCKNOW
(AFFILIATED TO LUCKNOW UNIVERSITY,LUCKNOW)
Select the subject (preferred by I & II)
Horticulture
Agriculture Extension
M.Sc. (Ag.) Admission Form 2015
Last date for submission of Application Form
Without late fee:
20/07/2015
With late fee (Rs. 200/-):
30/07/2015
Cost of Application Form
Application Fee (Draft)
– Rs. 20/– Rs. 1000/-
1. APPLICANT'S NAME (according to the High school certificate) (i) IN HINDI ..................................................................................................................
(ii)IN ENGLISH (BLOCK LETTERS)
Paste recent
Photograph
attested by the
Principal of
College last
attended
2. FATHER'S NAME (according to the High school certificate) (i) IN HINDI .....................................................................................................................................
(ii)IN ENGLISH (BLOCK LETTERS)
3. MOTHER'S NAME (according to the High school certificate) (i) IN HINDI .....................................................................................................................................
(ii)IN ENGLISH (BLOCK LETTERS)
4. DATE OF BIRTH 5. SEX -
MALE
DAY
MONTH
YEAR
FEMALE
6. CATEGORY (Please tick (
) in the box) –
(i) GEN
(ii) OBC
(iii) SC
(iv) ST
(v) College Employee
7. QUALIFYING EXAMINATION (Please tick (
) in the box) –
(i) Appearing
(ii) Passed
8. ARE YOU SPORT PERSON ?
YES
NO
IF YES WHETHER (i) District Level
(ii) State Level
9. DETAILS OF BANK DRAFT –
(i) Draft No. - .............................. (ii) Issue Date - ..............................(iii) Amount Rs. - ........................
(iv) Name & Branch of the Bank - .............................................................................................................
10. ADDRESS –
Mailing Address -
Permanent Address -
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PIN CODE ..........................................................
PIN CODE ...........................................................
Mobile No. ..........................................................
Mobile No. ...........................................................
11. DECLARATION –
I ..................................................................................... hereby declare that all the particulars stated
above have been filled in by me in my handwriting and true to the best of my knowledge and belief and no
fact has been suppressed/distorted. I have read the instructions and I shall abide by the terms and conditions
there in. In case any information furnished by me is found wrong at any stage my candidature for the
entrance test be cancelled outright without giving me any opportunity and further disciplinary action be also
taken against me including cancellation of admission/degree acquired. Further, if admitted I promise to abide
by the rules and norms of discipline of the college I join.
Signature of Candidate
Date :
Place :
Signature of Father/Guardian
CERTIFICATE IN RESPECT OF SON/DAUGHTER/SPOUSE OF THE EMPLOYEE
(of C.B. Gupta Agriculture P.G.College, B.K.T., Lucknow)
I ................................................................. hereby certify that Sri/Smt ................................................................................
mother/husband/wife of Sri/Km./Smt. .............................................................................. who has applied for the admission to an
M.Sc.(Ag.) programme through Entrance Exam 2015 holds the regular post of ................................................... in this College.
Date :
/
/ 2015
Signature with seal of the
Principal
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