REGISTRATION CUM ADMISSION FORM
PATNA SAHIB GROUP OF COLLEGES
Bhagwanpur (Vaishali) Bihar
Registration Number………………..
(For office use only)
PS College of Engg. & Tech.
B. Tech CSE ECE CE EE ME
Diploma CSE ECE CE EE ME
1. Name of the Applicant as per Matriculation:
2. Father’s Name:
3. Mother’s Name:
4. Nationality: 5. Date of Birth: 6. Sex. 7. E-mail Address:
M F
8. Blood Group: 9. Category 10. Religion
11. Complete Address for Correspondence:
12. Phone Number with STD Code
13. Mobile No. (Student)
14. Mobile No. (Parents)
15. Permanent Address:
16. Educational Qualification
Exam Passed Board/School Board/School % of Aggregate Remarks
Marks
10th
10+2 or
Equivalent
3 or 4
Years Diploma
Bachelor Degree
*AIEEE Roll No……………………….. Rank (STATE ……………………
National………..
*JET Roll No…………………………… Rank………………………………
17. Hostel Accommodation: Required (Yes/No)
18. Bus Facility: Required (Yes/No)
DECLARATION BY THE APPLICANT
I , hereby certify that I have read and understood all the rules and regulations
regarding my admission in *PSGC, Bhagwanpur (Vaishali) and all the particulars
stated in this application form are true to the best of my knowledge and belief. In
the event of suppression or distortion of any fact like education qualification,
nationality, etc made in my application form, I understand that my admission is
liable to be cancelled. I understand that college has the riht to add/delete/change the
rules and regulations as and when required.
Place:
Date: Signature of
Candidate
FATHER/MOTHER/GUARDIAN’S UNDERTAKING
My son/daughter/ward …………………………………………………………….. is
seeking above admission with my consent. I undertake to pay his/her college fees,
canteen dues and other expenses at the college. I also agree that he/she will abide by
the rules and regulations of the college authorities.
Place:
Date: Signature of
Father/Mother/Guardian
DOCUMENTS TO BE ENCLOSED
The applicant is required to enclose the following supporting documents in original:
Matriculation Certificate
10+2 pass certificate or equivalent (For admission to 1st Year B. Tech
only)
ITI Certificate (For Lateral Entry Admission to 2nd year Diploma Engg.
Only)
Migration Certificate (if required)
Gap Certificate (if required)
*Tick/Fill as applicable
COLLEGE PHOTOGRAPH
GUIDE MAP :
Patna Campus Muzaffarpur
PSGC
HELPLINE : 0612-6500617, 6500618, 6500619, 9263709120,
9263672717
Webiste : www.pscet.in e-mail : ggs.patna@gmail.com