Course Information
Course Applied For Stream
Year/Sem
Applicant’s Information
  Name
Do Not Write(Mr./Ms./Mrs./Ku.)
   
Upload Photo


  Father's/Husband's Name
Do Not Write(Mr./Dr.)
Mother's Name
Do Not Write(Mrs./Dr.)
  Sex Religion
  Category Class
  Blood Group Marital Status
  Nationality Indian Other Date of Birth
  Email Id    

Parent's/Husband's Address

  Permanent Address City  
  District State  
  Country
Zip/PinCode  
  STD Code Telephone No  
  Mobile No Email Id  
  Father's/Husband's Profession Father's/Husband's Annual Income  

Father's/Husband's Office Address

  Office Name Address  
  Telephone With STD code Mobile No  
 

OutStation Student

(Tick Here if you are OutStation Student)  
 
 
 

Prefrence to join NCC/NSS/Sports/Cultural/Literacy Activities

NCC NSS Sports Cultural Literacy Activities  
 

Sports ,Cultural & Other Co-curricular Activities Profile

     
 
S.No. Activity/Competition Achivement Year of Achivement
 
 

Educational Profile

Exam Board/University School/College Subject/Group Year Of Passing % of Marks
 

Parent's/ Guardian's /Relative's Photograph

 
 

Name

Name

Name

Relation

Relation

Relation

 
  Date Place  
           

Details of Enclosed Documents

  1.H School Marksheet(10th) (copy) 5.Character Certificate  
  2.H Secon. Marksheet(12th) (copy) 6.T.C+C.C(combined)  
  3.Graduate Marksheet(final) (copy) 7.Gap Certificate  
  4.Transfer Certificate 8.SC/ST/OBC Certificate  
  Total No. of document enclosed      

Details of Form Fee

   DD No
DD Amount  
  Bank  Issuing Branch  
  Date