Application for B.D.S Course 2011-2012

Starting April 17, 2011 - Ending May 30, 2011

Details inside

D.A. PANDU MEMORIAL R.V. DENTAL COLLEGE & HOSPTIAL

(Recognised by Dental Council of India, Affiliated to RGUHS, Karnataka)

No. CA 37, 24th Main, Ist Phase, J. P. Nagar, Bangalore – 560078

Phone : +91 (08) 26547053 / 22445754. Fax : +91 (08) 26658411

E-mail : rvdc@vsnl.com website : www.rvdentalcollege.org

 

Estd : 1992

       APPLICATION FOR BDS COURSE – ACADEMIC YEAR 2011 - 2012

1

Name of the Applicant  (In Block Letters)

 

2

Name of the Parent :   (In Block Letters)

 

a) Occupation             b) Annual Income

 

3

Permanent Address    (In Block Letters)

 

 

MOBILE No. & Tele.No.

 

 

4

Mobile No. of Student

 

5

E-MAIL I.D. of Parent

 

6.

E-Mail I.D. of Student

 

7

Local Guardian Name and Address

(In Block Letters)

 

MOBILE No. & Tele.No

 

 

8

a) Nationality

b)Religion and Caste

 c) Whether you belong to  Scheduled Caste /tribe ?

 

 

d)Sex

 

 

e)Date & Place of Birth

 

f)Blood Group

 

 

 

 

 

 

       
   

 


       

             M               F

 

           
     

 


……                  …..……………….

9

Details of Qualifying Examination Passed

Examination

Name of Institution or Board or University

1) Month & Year of passing

 

2) Reg. No.

PCBE

PCB

 

 

 

Max Marks

Marks Obtained

%

Max Marks

Marks Obtained

%

a) Pre – University or Intermediate Examination   ( 10 + 2 years Course)

 

 

 

 

 

 

 

 

b) B.D.S.

 

 

Max Marks :-

 

Marks Obtained :-

Percentage

10

Category of Seat

CET / PGET

COMEDK

MGT : NRI / FOREIGN

 

Rank and  %

 

 

--NA--

                     

 

                                                                       

 

DISCIPLINE DECLARATION

Text Box: I…………………………………………….Son / Daughter of ……………………… hereby agree to conform to the rules and regulations of the College including those relating to the Hostel, if any, laid down or to be laid down hereafter by the Principal of the College or the Management for the due maintenance of discipline at the said college and I further agree to make good, when called upon to do so, and damages to furniture, apparatus or other articles which may be caused by carelessness, negligence or wantonness on may part.<br />
Signature of Parent / Guardian			                                 Signature of the Applicant

 

OFFICE ORDERS

Text Box: The Applicant …………………………………… Son/Daughter of …………………………….is selected for admission to the First Year B.D.S./M.D.S. Course during the year 20………20………<br />
Date            :							                        PRINCIPAL										            D.A.PANDU MEMORIAL<br />
Receipt no. :							            R.V. DENTAL COLLEGE

 

 

 

Text Box: 1.	Candidate must have passed in the subjects of Physics, Chemistry, Biology & English individually and must have obtained a minimum of 50% marks ( 40 % in the case of SC, ST, OBC) taken together in Physics, Chemistry & Biology at the qualifying examination. This is applicable to admission for BDS.<br />
2.	Anti ragging committee is formed as per directions of Hon’ble Supreme Court of India, vide orders dtd.16.05.2007 in SLP ( C ) No. 24295/2004 as per DCI circulars DE167-2008/A142 dtd. 04.04.08 & 03.06.08.<br />
3.	Hostelites are informed to strictly adhere to the rules and regulations of the hostel.INSTRUCTIONS TO APPLICANTS

 

 

 

 

 

ORIGINAL DOCUMENTS REQUIRED

-----------------------------------------------Tear Here---------------------------------------------------

 

 

 

I YEAR B.D.S.      (  2011 – 12 )

 

ORIGINAL DOCUMENTS REQUIRED / SUBMITTED

(ORIGINAL + 2 XEROX COPIES)

 

Name of the Candidate………………………………………

Sl. No.

Nature of Document

Original Submitted to(Yes /No)

Xerox 2 sets

CET/COMEDK

COLLEGE

 

1.

10th Marks Card

 

 

 

2.

12th Marks Card

 

 

 

3.

Transfer Certificate

 

 

 

4.

Migration Certificate *

 

 

 

5.

Eligibility Certificate *

 

 

 

6.

Study Certificate

 

 

 

7.

Income / Caste Certificate (if Applicable)

 

 

 

8.

NRI Sponsor Letter (For NRI)

 

 

 

9.

Copy of Pass Port / Visa **

 

 

 

10.

Copy of Foreign Registration    *** Certificate / Copy of Residential Permit issued by FRO, Bangalore

 

 

 

 

11.

CET / COMEDK Allotment Letter

 

 

 

12.

CET / COMED K Rank Card

 

 

 

13.

Fees Paid Receipt from CET / COMED K

 

 

 

14.

College & University fees depending upon MGT / COMED – K/CET quota

 

15.

6 Passport Photographs

 

 

*    (For CBSE / Non Karnataka / NRI / Foreign Students)

**  (For NRI / Foreigner)

*** (For Foreigner)

 

Date :                                                                                    Signature of the Candidate

 

 

 

I acknowledge receipt of (                          ) ORIGINAL documents as stated above.

 

 

 

Date :                                                                                                               Principal

 

  

 

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