1. No category

Serial No.:
CHANDRA BHANU GUPTA AGRICALTURE P.G. COLLEGE
BAKSHI KA TALAB, LUCKNOW
(AFFILIATED TO LUCKNOW UNIVERSITY, LUCKNOW)
B.Sc. (Ag.) Entrance Exam 2015
2015
Last date for submission
Without late fee
: 15/05/2015
With late fee (Rs. 200/-): 25/05/2015
Cost of Application Form – Rs. 20/Entrance Exam Fee
– Rs. 500/-
Entrance Exam – 07/06/15
Time: 12:00 Noon to 1:30 P.M.
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
(iv) ST
(v) College Employee
7. QUALIFYING EXAM GROUP (Please tick (
) in the box) –
(i) Intermediate (Ag.)
(iii) Intermediate (Maths)
(ii) Intermediate (Bio.)
(iii) SC
8. QUALIFYING EXAMINATION (Please tick (
) in the box) –
(i) Appearing
(ii) Passed
9. ARE YOU SPORT PERSON ?
YES
NO
IF YES WHETHER (i) District Level
(ii) State Level
10. DETAILS OF BANK DRAFT –
(i) Draft No. - .............................. (ii) Issue Date - ..............................(iii) Amount Rs. - ........................
(iv) Name & Branch of the Bank - .............................................................................................................
11. ADDRESS –
Mailing Address -
Permanent Address -
..............................................................................
..............................................................................
..............................................................................
..............................................................................
..............................................................................
..............................................................................
..............................................................................
..............................................................................
PIN CODE ..........................................................
PIN CODE ...........................................................
Mobile No. ..........................................................
Mobile No. ...........................................................
12. 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
....................................................... ............................................................ father/mother/husband/wife of
Sri/Km./Smt. .............................................................................. who has applied for the admission to an
B.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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Serial No.:
CHANDRA BHANU GUPTA AGRICALTURE P.G. COLLEGE
BAKSHI KA TALAB, LUCKNOW
(AFFILIATED TO LUCKNOW UNIVERSITY,LUCKNOW)
B.Sc. (Ag.) Entrance Exam 2015
Admit Card
(Filled by office)
Roll No: .............................
Date of Examination: 07/06/15
Examination Center: CHANDRA BHANU GUPTA AGRICULTURE P.G. COLLEGE
Time: 12:00 Noon to 1:30 P.M.
BAKSHI KA TALAB, LUCKNOW
(Filled by Student)
Name : .................................................................................................................................
Father's Name : ..................................................................................................................
Paste recent
Photograph
attested by
the Principal
of College
last attended
Mother's Name : .................................................................................................................
Exam Co-ordinator
Serial No.:
CHANDRA BHANU GUPTA AGRICALTURE P.G. COLLEGE
BAKSHI KA TALAB, LUCKNOW
(AFFILIATED TO LUCKNOW UNIVERSITY,LUCKNOW)
B.Sc. (Ag.) Entrance Exam 2015
Verification Card
Examination Center: CHANDRA BHANU GUPTA AGRICULTURE P.G. COLLEGE
BAKSHI KA TALAB, LUCKNOW
Date of Examination: 07/06/2015
Time: 12:00 Noon to 1:30 P.M
Roll No: .................................
(Filled by Student)
Name : .................................................................................................................................
Father's Name : ..................................................................................................................
Mother's Name : .................................................................................................................
Student's Signature
Paste recent
Photograph
attested by
the Principal
of College
last attended
Invigilator's Signature
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