College of Education

Morigaon: Assam

Application Form for B. Ed. Course.

Affix your recent Passport size Photograph

 

1)      Name of the candidate        : ______________________________________

(In Block letters)

2)      Father�s Name                      : ______________________________________

3)      Mother�s Name                   : ______________________________________

4)      Guardian�s /                          : ______________________________________

Husband�s  Name 

5)      Home address                     : ______________________________________

         ______________________________________

6)      Address for                           : ______________________________________      

Communication                    ______________________________________

7)      Race & Religion                   : ______________________________________

8)      Nationality                           : ______________________________________

9)      Whether Employed /         : ______________________________________

Unemployed 

10)   Sex (Male / Female)          : ______________________________________

11) Date of Birth :                      : ______________________________________

12)  Registration

Number                              : ______________________________________

13) Date of Passing B.A. / B. Sc / B. Com_______________ Roll No. _________

14) Academic Career (H.S.L.C. onwards:

 15) Method subject offered  :  1.                                               2.

16) Optional subject offered :  1.                                                

Certified that above information are true and correct to the best of my knowledge and belief. I understand that in the event of any information being false or incorrect or ineligibility being detected before or after the admission, my candidature is liable to be canceled.

Date _______________                                                                             

Place _______________                                                                                           Signature of the candidate

 FOR OFFICE USE ONLY

After verification of all the documents the candidate is provisionally selected for the session______________ 

Checked and Verified by

                                                                             Roll No. ___________

_____________

Office Assistant                                                                                                                              PRINCIPAL