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ONLINE ADMISSION FORM


Application Fee : ₹ 500

1. Course Applied For:


2. Name of The Candidate:


3. DOB:


4. Gender:


5. Blood Group:


6. Marital Status:


7. Mother Tongue:


8. Nationality:


9. Religion:


10. Community:


11. Aadhar No:


12. Contact No :


13. Mail Id:


14. First Graduate of The Family:


Yes No

15. Special Admission Quota:


Yes No

16. Differently Abled:


Yes No

17. Communication Address:


As Same

18. Permanent Address:


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19. Qualifying Examination Particulars:



Exam
School Name
Medium
Overall %
Year of Passing
Register No
Certificate No

20. Mark Obtained in Higher Secondary Examination:



Subjects
Marks Secured
Maximum Marks
Month & Year Of Passing
No of Attempts

21. Mark Obtained in Diploma:



Subjects
Marks Secured
Maximum Marks
Month & Year Of Passing
No of Attempts

PHOTO


DOCUMENT


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22. Hostel Accommodation:

Yes No

23. Transport Facility:

Yes No

24. Are You From Sports / NCC / NSS / YRC / RRC:


25. Particulars Of The Parents / Guardian :



Father / Guardian
Mother / Guardian
Name
Qualification
Occupation
Annual Income
Address
Mobile / Landline
Email

26. Reference :



Reference Name
Reference Mobile Number
Reference Designation


Application Fee ₹ 500/-

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