ADMISSION FORM
SURYADATTA PUBLIC SCHOOL
HIGHER SECONDARY SECTION OF ARTS, COMMERCE AND SCIENCE (SPS)
Recognized by Govt. of Maharashtra (U-DISE Code - 27251014727) Index No. : J11.10.012
ISO 9001 : 2008 Certified College and Accredited by NVT-QC, ANAB and IAF
HOLOGRAM
Campus : S. No. 342, Bavdhan (BK) Pune 411 021, Maharashtra, INDIA
Tel.No. : 020-67901300 / 328 / 310 (M) : 8956943822, 9763266829 Fax No. : 020 - 67901333
Email : admission@suryadatta.edu.in Website : www.spspune.org
To
The Principal Application No. :
Suryadatta Public School
Dear Sir,
I have gone through the information brochure of Suryadatta Public School and am interested in taking Affix your
photograph
admission in_____________________________________________ Course for the academic year
_______________. I am submitting my application as under
(Optional : Hindi French IT ) Other ________________________________________
A. GENERAL INFORMATION : (IN BLOCK LETTERS) (Name of the applicant should be as per Certificate of the last
qualifying examination In case of name change, attach the required document.)
Full Name
First Name Middle Name Last Name
Student’s Contact No : Alternate No :
E-mail ID : Aadhaar Card No. :
(Ensure your contact no. is correctly recorded as Suryadatta sends many important messages via SMS. Any change in Address /
Contact No. / Email must be communicated to Suryadatta immediately.)
Date of Birth : Age _________ Year _________ Months (as on 1st July 2018)
D D M M Y Y Y Y
Gender : Male Female (Tick Appropriately) Nationality : Religion :
Father’s / Guardian’s Name :
Professional Background of Father/Guardian : Designation :
Mobile No (Father): Residence No.
(including STD Code)
Mother’s Name :
Professional Background of Mother : ______________________________________ Designation : _________________________
Email ID : Father _________________________________________ Mother ____________________________________________
Family’s Yearly Income : _____________ Sources of Income : ________________________________________________________
Do you have any Brother(s), Sister (s). If so, their name & present occupation : ____________________________________________
____________________________________________________________________________________________________________
B. POSTAL ADDRESS (IN BLOCK LETTERS) Please use spaces and / or commas wherever applicable.
Communication Address : (Students should take utmost care in writing complete address so as to receive all communication.
City :
Pin : State : Country :
Permanent Address :
City :
Pin : State : Country :
C. DETAILS TO BE FILLED BY FOREIGN STUDENTS
B) HOBBIES & INTEREST
Passport No. : ___________________________ Passport Issued : ______________________ Valid Till : _____________________
Visa No. : ___________________________ Visa Type : ___________________________ Valid Till __________________
Nationality : ___________________________________ Country __________________________________________________
Any Relative in Pune / India : Name ___________________________________________ Relationship ______________________
Contact No. : ____________________________ Email ID : ________________________________________________________
Address: ________________________________________________________________________________________________
_______________________________________________________________________________________________________
Board Exam given : ________________________________________________________________________________________
D. ACADEMIC DETAILS
It is mandatory to mention your academic details, without which, your form will not be processed.
Year of Subject Marks Class /
Exam Board School / College
Passing Specialisation in (%) Grade
Xth / SSC
XIth (if apphse)
Other Examinations (Please specify)
School / College / Institute Board / University Year of Degree & Final Grad
Course Title
Completion Specialisation / Marks in %
Computer Literacy : _____________________________________________________________________________
E. EXTRA-CURRICULAR ACTIVITIES This is not a compulsory part. Only those claims which can be substantiated with
legitimate certificates need to be mentioned here. Attach separate sheet if required. List not more than three significant
achievements in extra-curricular activities.
Sr. What personal traits/qualities do you believe
Achievements Level Year
No. were instrumental in this achievement?
Languages Known : _________________________________________________________________________________________
Hobbies & Interest : _______________________________________________________________________________________
Mention your Strengths and Areas of Improvement : _____________________________________________________________
_________________________________________________________________________________________________________
Why do you think SURYADATTA is the best option for you? _________________________________________________________
_________________________________________________________________________________________________________
Health Records : Height _________________ Weight ________________ Blood Group ________________________________
Any major ailment or continuing health problem _________________________________________________________________
F. OTHER DETAILS
a) CAP details (If applicable) Yes No
b) Category : (Please tick appropriately) OPEN SC ST OBC NT SBC category
Yes No
If from reserved category attach Non Creamy Layer, Cast Validity Certificate from competent Govt. authorities.
c) Are you attaching your Domicile & Nationality Certificate : Yes No
d) Are you a physically handicapped candidate : If yes, attach disability certificate from competent authorities. Yes No
e) Are you an outstanding performer in Academics (Medalist or Rank Holder) in the University / Board Yes No
If yes, attach supporting document signed by competent authorities
f) Did you have any gap in your continued education. If yes, attach your gap certificate state reasons for the same. Yes No
Your source of information about our Course : (Please tick wherever applicable)
a. Newspaper advertisements Yes No b. Magazine Yes No
If Yes, specify the name of the Newspaper : ___________________ Name of Magazine : _________________________
c. Internet Yes No d. Alumni Yes No
If Yes, specify the name of the website : _____________________ Name of Alumni : ___________________________
e. Current Students Yes No f. Parental Reference Yes No
If Yes, name of the Student : ______________________________ g. Any other source : __________________________
Hostel Facility : Yes /No If Yes Only Boarding Boarding & Mess
Preferred mode of Payment for fees : Own Source Education Loan
Documents to be submitted - Copies only
1. Mark sheets of all examinations
2. Transfer Certificate & Migration Certificate
3. Valid Proof of Address (Submit Photo Copy of any one of the following document)
a. Driving Licence b. Passport c. Voter’s ID d. Aadhar Card e. Ration Card
4. Four Passport Size Photographs
Note : Original Degree need not be attached at this stage. Original Certificates are required at the time of admission. Those not
meeting the eligibility criteria of the board will attract cancellation of admission.
Students can collect their original documents after clearing all dues & getting a ‘No Dues’ certificate from the College authorities.
G. RULES & REGULATIONS
● Admission Rules :
1) Applica on for admission to all courses must be made on the prescribed applica on form only. Photocopies of the form are unacceptable.
2) All admissions are confirmed subject to the candidate fulfilling all the eligibility criteria and payment of requisite fees.
3) Fulfilling the Eligibility criteria in itself does not assure admission to a course. The final decision to admit a candidate rests with the College. Admission is
not transferable to any other individual.
● Attendance : Regular class attendance of minimum 80% is mandatory and a student is responsible for all the work, including tests, assignments, field
work, project, written work of all classes. Absence from test / exams / tutorials & non-submission of assignments on time disqualify the students for
internal assessment.
● General Norms and Guidlines for students :
1) No student is allowed to enter the class / knock at the door or leave the class once the Faculty is in the classroom. Students cannot request the Faculty for
cancellation of lectures. Peeping into classrooms, gesticulating and so on while the lectures are in progress are construed as acts of misconduct.
2) Smoking, use of mobile phones, consumption of tobacco, alcoholic drinks and drugs are strictly prohibited / not allowed.
3) Students should conform to the prescribed decorum and always be in uniform.
4) Students should keep themselves abreast of the day-to-day activities of the College and abide by all the communication put up on the notice boards.
5) Misbehaviour, late coming, disobedience, absenteeism, consumption of drugs & alcohol, malpractice, cheating in exams will automatically leads to shall
disciplinary action.
6) The College Principal & Directors are empowered to impose fine for any misconduct as and when warranted and justified.
7) Career Progression including Attendance, Academic Record and Disciplinary Record will be sent to the parents for information. It is expected that
parents take cognizance of the same and report to the College and meet the Principal as and when requested through Letter / Mail / Phone /SMS.
8) Students must wear the prescribed uniform and must carry their Identity Card at all times, in the College premises and during official visits.
9) Every student must notify the College office of any change in name, address or contact number. Failure to do so can cause serious delay in the handling of
the student’s records and in notification of emergencies at home.
Rules & Regula ons Con nued........
10) The College authori es cannot be held responsible or liable for any loss of belongings of the students.
11) The student should not participate in any political or antisocial activities, otherwise the student is liable to be expelled from the college.
12) Ragging is strictly prohibited and shall attract penal action as defined by the Government / College rules.
13) For any breach of conduct outside or inside the College the student is liable to punishment as per the rules and regulations.
14) The College reserves the right to demand compensation, equivalent property to the original price, for equipment, component or instrument damaged
by student.
15) Students are advised to use IT facili es to the fullest extent possible in order to improve their overall technical skills.
16) Each class will have two students selected as Class Representa ves and two more students to be a part of the College Discipline Commi ee. They are
expected to report to the Faculty–in-Charge on a day-to-day basis & when necessary directly to the Principal / Director. Students who have any problem
or grievances can directly approach the faculty members / Professors / Principal / Directors for a fair resolu on.
17) The rules and regula ons of Local / State / Central Government Bodies and that of the College should be strictly adhered to. The rules laid down by
competent authority such as DTE, UGC, University and the College authority shall be applicable from me to me and shall be binding to all the students.
18) The College reserves the right to amend, modify and change all norms, rules and regulations from time to time.
19) In case of disputes, the decision of the College head shall be treated as final. All litigations are subject to Pune jurisdiction only.
● Medical Fitness : Students are directed to submit medical fitness cer ficate.
1) It is in the interest of the students that if anyone has any serious health problems, they should not take admission in our College because the College is not
liable for their medical problems. However, if anyone develops this kind of illness during the Course, it should be brought to the notice of the College
Immediately.
2) Any medical emergency if arises is likely to be managed with hospitalization. Students are expected to take care of themselves.
● Submission of SSC / HSC / Degree Certificates : Students should submit certified mark sheets of the qualifying examinations latest by 1st October failing
which the allotted admission stands cancelled automatically. In case any Board / University has not declared the results by then, the Principal of the
College where the student studied should personally write to the Director / Principal of the college explaining the correct situation and the Principal /
Director will take appropriate decision in the interest of the applicant. No refund of fees will be permissible in such cases. In case, any discrepancy is found
at any stage of document / marksheet verification by college / authorities, the admission of the student will be cancelled. No fee refund will be permissible
in such cases.
● Compliance by the students belonging to reserved category : In case of the students belonging to Government declared reserved category, if the fee
concession / scholarship cannot be availed due to insufficient documents / late submission of the documents / non compliance with provisions of
prevailing acts and rules and regula ons of government bodies / changes in the government rules regarding eligibility criteria for such fees concession or
scholarship, the students will have to pay the full fees of the course in which they have the admission. Non payment of full fees will automa cally result
into cancella on of the admission of the student and further deemed suitable disciplinary ac on against the student by the college.
● Fees Structure and Rules :
1) All fees are payable by Cash / Demand drafts / Account Transfer / Card Swap. Cheques are NOT accepted.
2) Please Refer our introduction letter for course details & fees structure.
3) Fees once paid will not be refundable.
4) Prospectus and Registration Charges paid will not be refunded.
5) Full fees are to be paid before joining the college. After registration, change of course / transfer / cancellation is not allowed.
6) Students must clear all dues, monetary or otherwise, prior to the semester exams, otherwise he/she may be debarred from appearing for the same.
7) Once admission is confirmed and course has commenced, student must pay the entire course fee as per the schedule. Late fees charges as applicable,
shall be charged for delays.
8) On request for cancellation of admission, you are liable to pay the entire course fees.
9) No capitation fees is charged for admission to any course offered by Suryadatta.
H) CERTIFICATE OF UNDERTAKING : I DECLARE AND UNDERTAKE THAT -
1) I have read, understood and accepted all the codes for discipline, academic standards, rules & regulations & mandatory information as
mentioned in the admission prospectus, website, undertaking of the college & I shall take note of all communication put from time to time.
2) I am aware that ragging is strictly prohibited in all Educational Institutes as per the Supreme Court Order & Govt. rules & I will not indulge myself
in ragging and activities of similar nature, failing which I shall be liable for punishment / disciplinary action.
3) I have read & understood details about the course for which I have taken admission & I have signed the undertaking after consulting my parents
/ guardian & after reading all rules & Regulations pertaining to the course for which I have taken admission.
I hereby declare that the above given information is correct and true to the best of my knowledge and belief.
We assure that who has filled up above form with our consent, will abide by rules & regulations of the institute and local authorities.
No information pertaining to my / our ward be parted with, to any person unless expressly authorised by me/us.
Date
Place Signature of Applicant Signature of the Parent / Guardian
For office use only
Admission taken by : Signature :
Remarks of the counselor / Principal :
Signature of Principal : Date :
