Program Course – Ghoom Jorebunglow College

Online Application Form (2026-2027 )

B.A in Program Course

Student Name:*

Date of Birth:*

Marital Status:*

Gender:*

Physically Challenged:

Cast Category:*

Phone Number*

Country*

Aadhar No:*

Blood Group:*

Email Address:*

Religion:*

Parental & Address Details

Father's Name:*

Father's Occupation:*

Mother's Name:

Mother's Occupation:

Contact No:*

Annual Family Income:*

Communication Address:*

Permanent Address:*

Academic Qualification

Name of the School:*

Name of the Board:*

10+2 Registration Number:*

Year of Passing:*

Marks Statement

Subject 1*

Marks 1*

Subject 2*

Marks 2*

Subject 3*

Marks 3*

Subject 4*

Marks 4*

Total Marks

Percentage

Subject Combination

Major Subject

Group A*

Group B*

Group C*

IDC1 (2nd Sem) *

IDC2 (3rd Sem) *

IDC3 (4th Sem)*

AEC1 *

AEC2 *

SEC1(1st Sem)*

SEC2 (2nd Sem) *

SEC3(3rd Sem) *

VAC 1*

VAC 2*

Declaration

I hereby declare that all the information furnished above is true to my knowledge. If found incorrect, my candidature shall be canceled. I shall abide by all the rules and regulations of the institute.

Date

Place:*

Passport Photo*

Marksheet *

Upload Aadhar Card *

Student Signature*