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APPLICATION FORM

Full name of the applicant

Date of Birth

DD MM YYYY

Gender

Male Female

Nationality

Religion

Caste

SC ST BC BT

Course applying for

% Marks obtained

 

10th

PUC/+2/Higher Secondary

Degree

Others

 

Permanent Address

Phone with STD Code

Address for Correspondence

Mobile number

Name of the Parent/Guardian
(If parent is not alive):

Occupation of the Parent/Guardian
And annual Income

Whether the candidate is and NRI Foreign National

Yes No

Local Address

Phone with STD Code

Highest Exam Passed with Year

Name of the school/college last attended with address

Date of leaving the school/college

Tick the Course applied For:

Email