Progressive Education Society’s
Modern College of Arts, Science and Commerce
Ganeshkhind, Pune - 411 053
Website www.moderncollegegk.org
E-mail info@moderncollegegk.org
Phone: (020) 25634021 Fax: (020) 25650931

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MERIT FORM

FORM NO: 833

Admission for
M.Sc. I (organic Chemistry) Academic Year: 2010-2011
To,
The principal,
Modern College of Arts, Science and Commerce,
Ganeshkhind, Pune – 411053.

Sir,
I the undersigned

Surname	Name	Father’s/ Husband Name
(IN BLOCK LETTER)

Permanent Address ______________________________________________________________

                                ______________________________________________________________

Contact No. Home _________________________________Mobile No.____________________

E-mail _______________________________________________________________

Wish to apply for the admission to the M.Sc. (I) organic Chemistry course at your college.
PUNE UNIVERSITY      OTHER UNIVERSITY    

Category	OPEN	SC	ST	VJNT(A)	NT (B)	NT(C)	NT(D)	OBC	SBC

Name and address of the college last attended

Principal (Chemistry) total S.Y. + T.Y. marks ____________________out of ________________

Please write only chemistry subject marks for F.Y.B.Sc., S.Y.B.Sc. and T.Y.B.Sc.

Year	Name of University	Year of Passing	Marks obtained	Out of	Percentage %
F.Y.B.Sc.
S.Y.B.Sc
T.Y.B.Sc.

Note: 1) Attach attested Xerox copy of mark list of F.Y., S.Y. and T.Y.B.Sc.
2) Attach attested Xerox copies of caste certificate and cast validity certificate.
(if applicable)

Date:          /          / 2010                                                                                                                                              (Signature of students)