ONLINE APPLICATION – DLIHE

APPLICATION FORM


    FULL NAME SEX:

    DATE OF BIRTH
    PLACE OF BIRTH


    Father's Name
    Mother's Name

    Permanent Address

    District

    State

    Pin Code


    CORRESPONDENCE ADDRESS FOR COMMUNICATION



    CONTACT DETAILS


    MOBILE NUMBER EMAIL


    SCHOOL


    FEE SOURCE


    PLEASE TICK THE COURSE YOU ARE APPLYING FOR



    EDUCATIONAL QUALIFICATION

    Exam Passed

    Year

    Stream

    Percentage [ best5(2+3)]

    Board / University


    By Submitting this form I certify that the above information is correct to the best of my knowledge. I promise to abide by the rules and regulations of the institute.


    keyboard_arrow_up