Fields marked * are required · download the printed form

1. Admission Details

Course Applied For

Academic Session

Hostel Required

YesNo

2. Student Personal Information

Full Name (In Block Letters)

Date of Birth

Gender

MaleFemaleOther

3. Parent / Guardian Information

Father's Name

Mother's Name

Father's Occupation

Mother's Occupation

Father's Mobile No

Emergency Contact Person

Name and mobile number

4. Address Information

Permanent Address

Address

City / Town

District

State

Pin Code

Correspondence address is the same as above

5. Academic Qualifications

Examination Passed	Board / University	School / College Name	Year of Passing	% / CGPA
10th Std / Secondary	Board / University	School / College Name	Year of Passing	% / CGPA
12th Std / Higher Sec	Board / University	School / College Name	Year of Passing	% / CGPA
Graduation / Other	Board / University	School / College Name	Year of Passing	% / CGPA

6. Declaration & Signatures

I hereby declare that all the statements and information furnished in this admission form are true, complete, and correct to the best of my knowledge and belief. I understand that in the event of any information being found false, incorrect, or incomplete at any stage, my admission/candidature is liable to be cancelled immediately without any notice or refund of fees. I also agree to abide by the rules, code of discipline, and academic regulations established by the School of Hospitality & Management (SHM), Durgapur, during the entire tenure of my course.

I have read and accept the declaration above, and I agree that SHM Durgapur may contact me by phone, WhatsApp, SMS or email about this application.

Date

Today's date, filled in for you

Place

Taken from your city above — change it if you are somewhere else

Signature of Student

Signature of Parent / Guardian

7. For Office Use Only

Application Status

ApprovedProvisionalRejected

Scholarship Awarded (if any)

Seat Booking Fee Payment Uploaded

YesNo

Amount Received (₹)

Enrollment / Reg No

Date of Admission

Verified By

Receipt No

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