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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


 
 
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