Ganganagar, Bengaluru
College Code - AN 354
PROVISIONAL ADMISSION FORM
ACADEMIC YEAR 20__|__ Karnataka
ADMISSION NO : COURSE INTERESTED IN : ( Please tick )
Non-Karnataka
SCIENCE
COMMERCE
PCMB (Integrated)
CEBA
PCMB (Non-Integrated)
SEBA
PCMC (Integrated) PCMC (Non-Integrated) Name of Candidate : ............................................................................................................................................ FILL IN BLOCK LETTERS
Date of Birth : __/__/____ Gender :
Male
Religion : .............................................
Mother Tongue : ............................. Female Caste : ................................................
Recent Passport Size Photograph
Email ID : ................................................................................................................. Board of Study (X Std) : ....................................................................................... School Name : ........................................................................................................................................................ Mobile No : ............................................................... Alt Mobile No : ............................................................... Parents or Guardian Name : .............................................................................................................................. Address : ................................................................................................................................................................. ..................................................................................................................................................................................... How did you hear about us / Reference : ...................................................................................................... Rukmini Educational Charitable Trust
www.revapucollege.edu.in
