Registration Form

Application Form

1.(A) Applicant's Name*

(B) Aadhaar Number*

2.Father's Name*

Mother's Name*

Student Image

Note: One photo for the identity card should be attached with the applicant eligible, keep in mind that five photos

Mobile No*

Session*

Course*

Year/Semester*

Date Of Birth*

Gender

Nationality

Religion

4.Present Address

5. Permanent Address

6. Mobile :

7. Local Guardian/Father Phone

8.Name And Address of local Guardian/Father

9.Category

GENERAL SC ST OBC EWS

10. Whether you are a PWD

YES NO

11. Wards of defence personnel

YES NO

12.do you belong to below poverty line BPL

YES NO

13.Name of Final Pass Exam

14.Name of Last Learning Institution

15. NCC

YES NO

16. NSS

YES NO

17.Sports

YES NO

18. Educational Qualification Details

YES
I hereby declare that all the above information are correct and assure that I will abide by all the rules.

Applicant's Signature:

In the applicant's eligible should be the same and latest.