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Admission Application Form (AY : 2019 – 2020)

To
The Director
Counselling & Admissions Office
Vishwakarma University, Pune.

Dear Sir / Madam

I hereby submit my admission application for Academic Year 2019 – 2020 as per details given below.

• Name of the Applicant :


• Full Address :
• Email ID : Mobile No. :
• Programme Applied For :
• Category : ( Open / OBC / SC / ST / VJ / DT / NT / SBC etc.) :
• Eligible for any other reservation category (Police / Defense / Physically Handicapped, J&K Migrant
etc.) :
• Academic Qualifications
Examination Board / University School / College Stream / Subject Percentage
Graduation
H.S.C.
S.S.C.
• Entrance Examination Details (If applicable)
Entrance Test (Name) :
Entrance Test Score & Percentile :
Merit Number (If any) :
Domicile Status :

DECLARATION

I hereby declare that information provided through this application is true, complete and correct to the
best of my knowledge and belief. I am fully aware that applying for the seat does not offer me any
assurance regarding my admission to the university / programme. I understand that I have to undergo
process of provisional admission and admission confirmation by submitting required certificates,
documents and fees to the University for various purposes as per schedule.

Date: Signature of the Candidate