Apply Online – S Nijalingappa Institute of Dental Science & Research

Application Form for BDS

Application Form for BDS Students.

Step 1 of 2

50%

Unique ID
Student Name*
Gender*
- Male
- Female
- Transgender
Date of Birth*
Age*
Please enter a value between 17 and 50.
Place of Birth
Religion*
Caste*
Nationally*
Native State*
Native District*
Native Taluka*
Mother Tongue
Father Name
Mother Name
Father Occupation
Mother Occupation
Mobile Number*
Father Mobile Number
Email ID*
Blood Group
PAN Card Number
Identification Mark on you
Last Qualification Course*
Examination of Board/University*
Total Percentage Secured*
Present Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Permanent Address*
Same as Present Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Marks Secured in PUC or 10+2 Equivalents

SL.No:	Subjects	Maximum Marks	Marks Obtained	Percentage
01
02
03
04
05
06
07
			PERCENTAGE

Enclose the following Original Certificates along with 4 xerox copies
1. SSLC Marks card
2. PUC or Equivalent Marks card
3. Birth certificate
4. Transfer Certificate
5. Migration Certificate
6. CET Admission card
7. NEET/COMED-k Rank Certificate
DISCIPLINE DECLARATION*
I am Seeking the admission to 1 year B.D.S declare that,
1. The informations furnished by me in connection with my admission is true and correct. In case of the information is found to be false or incorrect, I shall be for felt my claim and i will also be liable for any legal action.
2. I will be abide by the rules and regulations of the college laid down or to be laid down from time to time.
3. I will not indulge in ragging / undesirable activities in the college / hostel and outside the campus.
4. I will not cause any harm to the property. Furniture and other articles of the college.
5. I will not spoil or tear the library books.
6. I will pay the prescribed college within the stipulated period.
I further declare that in case I violate any of the above mentioned conditions or any other rules pertaining to the discipline etc. I may be punished and my admission may be cancelled at any time.

The above discipline declaration taken form my son, I will also agree with the same and also liable for such action any taken against in the behalf.

We the parents also agree with the above said rules and will also liable for such actions with may be taken against us.
- I agree to the Terms of Service