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.

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