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Jiten Mody Junior College

An ISO 9001 - 2015 certified

Mahavir Nagar, Kamla Vihar Sports Club Lane,
Near Poisar Gymkhana, Kandivali (W), Mumbai - 400 067,
Tel. : 022-28616071 / 28613915

APPLICATION FOR ADMISSION


Paste your recenet coloured passport size phtograph
(33mm x 45mm)
DO NOT STAPLE
STREAM.: YEAR.:
AADHAR CARD No.:

(to be filled in BLOCK LETTERS)
Student's Sign. Strictly inside
the box with black ink only.
Last Name / Surname First Name Middle Name

BLOOD GROUP.:
NATIONALITY.:
CURRENT ADDRESS:
CITY.: PINCODE.: STATE.:


PARENTS / GUARDIANS DETAILS

Father / Guardian 1 Mother / Guardian 2
NAME
OCCUPATION
CONTACT
EMAIL ID
ANNUAL INCOME

ACADEMIC RECORD

Name of the last Institution School / Jr. College.
Medium of Instruction :

Particulars of examinations passed :

Examination Name of Board or University Month & Year of Passing Exam Seat No. Total Marks Obtained Out of Maximum Marks Class or Grade & Percentage Total Marks Best out of five
S.S.C./I.C.S.E
or equivalent
Examination
(in case of equivalent examination, write the name of the examination)

OTHER INFORMATION

Special Merits : Medical History :

                                                                        

Note :

1. You will get PDF after submitting this form.
2. Send PDF to Provided Whatsapp link
3. Confirm your Admission by paying ₹5000/- in the given below bank details.
4. Send filled form PDF and Payment Screen Shot to the Provided link
5. CLICK HERE TO SEND

BANK DETAILS
Jiten Mody Junior College
A/c No.:013620110000599
IFSC:BKID0000136
Branch:Mahavir Nagar