Enrollment Form

Enrollment Form for Phd/Mphil and 3/5/7 Sem (from Other University) and Offline to Online:: JUL-2025

Field's marked with * are mandatory

Reference Details

Reciept No.*

Reciept Date*

College And Course Details

Course Type*		District*
College Name*
Program Name*		Branch*
Admission Type*		Medium*

Personal Details

First Name*	Last Name*
Name in Hindi*
DOB*	Gender*
Father's Name*	Mother's Name*
Marital Status*	Husband's Name
Category*	Sub-Category	Minority Handicapped
Nationality*	Religion*

Address

Correspondance

House No/ Village		Colony/ Post
City/ Tehsil*		State*
District		Pincode

Copy to Permanent Address

Permanent

House No/ Village		Colony/ Post
City/ Tehsil		State
District		Pincode

Other Details

Phone Number(With STD Code)		Mobile Number*	Email Id*

Previous Education Details

Exam Passed/Appeared:*
University/Board*
Passed/Appeared Year:*	Percentage*	. %
Eligibility/Migration/Transfer Certificate No.*	Vikram Univ Previous Roll No(For Ex)

Bank A/C Detail

Bank A/C No

Enclosures

Eligibility certificate?

Migration certificate?

Proof for DOB?

Marksheet?

Gap Certificate?

Declaration

I hereby declare that the information filled by me is true and complete as per my knowledge. If any information provided by me is found false or incorrect then i shall be disqualified by the university.

Photo & Signature*


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