Course applied for *
Student's/Candidate Name *
Father’s Name
Nationality
D.O.B
Blood Group
Gender *
Religion
Category
Premanent Address
Present Address
Mobile Number *
Contact Number(Parent)
Name Of Local Guardian(If Any)
Local Guardian Contact Number
Email Id
Academic Qualification 1
Examination passed
Year of passing
Board/University
Subjects
% Of Marks Obtained
CGPA / GDPA
Academic Qualification 2
Academic Qualification 3
Academic Qualification 4
Academic Qualification 5
Availing Hostel Facilities*
Total Distance from Home to Institute (Km)
Any Other Information Candidate Wishes to Share