Registration Form

Admission Form

Fill In the Application Form In Capital Letters

This application form is to be filled in applicants own hand neatly and legibly.

Only self attaested copies of testimonials and other documents be submitted as that will not be returned.

Original certificates and Mark sheets to be deposited, if selected.

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Please Tick

• S.C./S.T.
• OBC
• GEN

Session

COURSE APPLIED FOR

Name *

First

Last

Student Numbers / WhatsApp *

Student Email *

Mother Name *

First

Last

Mother's Mobile Number/Whatsapp

Mother's Email ID

Mother's Occupation

Father's Name *

First

Last

Father's Mobile Number / WhatsApp

Father's Email ID

Father's Occupation

Father's / Guardian's Income certificate / Documentary Evidence duly signed and issued by the competent authority of Govt. Deptt. / institution / Organisation etc

Date Of Birth *

MM/DD/YYYY

Nationality

Gender

Ph. Handicaped

• Yes
• No

N.C.C. "B" Certificate

• Yes
• No

Freedom Fitter

• Yes
• No

Religion

Permanent Address

Mailing Address

Aadhar Card No.

Academic Achievements

• High School
• Intermediate
• Graduation
• Post Grad.
• Any Other Qualification

Please select your qualifications.

High School(Name of Board/University | Name of Institution | Year | Subject | Marks Obtained | %of Marks | Division) *

Intermediate(Name of Board/University | Name of Institution | Year | Subject | Marks Obtained | %of Marks | Division) *

Graduation(Name of Board/University | Name of Institution | Year | Subject | Marks Obtained | %of Marks | Division) *

Post Grad. (Name of Board/University | Name of Institution | Year | Subject | Marks Obtained | %of Marks | Division)

Any Other Qualification (Name of Board/University | Name of Institution | Year | Subject | Marks Obtained | %of Marks | Division) (copy)

Submit

Note

Bank Account Detail