Demand Draft of Rs. 75/- in favour of Secretary Hamdard Education Society.

HAMDARD STUDY CIRCLE

APPLICATION FOR ADMISSION Form No. To The Director Hamdard Study Circle Talimabad, Sangam Vihar New Delhi 110 062 Sir, I wish to appear in the Civil Services Examination and would be grateful if I could be admitted to the Hamdard Study Circle for coaching and guidance. I shall abide by the rules and regulations of the Study Circle enforced from time to time. My admission may be cancelled anytime without notice if my performance and/or conduct are not found satisfactory. (USE CAPITAL LETTERS) 1. Name Mr / Ms (Surname first) 2. Fathers / Husbands Name 3. Date of Birth Date Month Year Affix your recent passport size photograph

4. Enter appropriate code in the box for category and community (attach attested copy of certificate in case of SC or OBC) Category Community 1. General 4. Muslim 2. S.C. 5. Hindu 3. O.B.C. 6. Christian 7. Sikh 8. Any other

5. Fathers / Guardians Occupation: _________________ and 6. Total Annual Income Rs. ______________________ 7 Mailing Address

e-mail ID Telephone No. 8

Permanent Address

PIN

Telephone No.

PIN

9. Educational Qualifications Examination passed High School Higher Secondary (+2) Graduation Post - Graduation Any other 10. Have you appeared in UPSC Civil Services Examinations earlier? If yes, give details below in ascending chronological order Examination Year(s) Preliminary Main Personality 11. Have you received coaching at H.S.C. earlier? If yes, give year(s) and details Yes/No Roll No. Result Year Board / University Div. % Subjects

12. Have you received coaching in any other coaching Institute, if yes, please mention the name of the Institute and year(s) 13. Have you received stipend for coaching from Ministry of S.J. & Empowerment earlier? If yes, write details 14. For which Examination coaching do you wish to be admitted to H.S.C.? Please strike out those not applicable CS Preliminary / CS Main / CS Personality Year 15. Choice of Centre for H.S.C. Admission Test (Enter appropriate code in the box) 1. Delhi 2. Chennai 3. Patna 4. Calicut 5. Thiruvananthapuram 6. Kolkata 7. Hyderabad 8. Guwahati 16. Optional Subject(s) offered for Civil Services Examination Preliminary Main 1. 1. 2. . Studied the above subject(s) offered upto (Enter appropriate code in the box) 17. Medium of language in Examination (Enter appropriate code in the box) 18. UPSC Roll No. __________________ Date:____/_____/________ Place:_______________ Signature 1. High School 3. Master level 1. English 2. Bachelor level 4. Never studied 3. Urdu 4. Any other

2. Hindi