Student Details

Name of the Applicant
DOB
Sex
Telephone Number Landline  :
  Mobile      :
  Email       :
Address for Communication
Religion
Specify :
Nationality
ACADEMIC RECORD  
Examination Board/ University Month/Year Passed Subjects Grade / Class/ Percentage
SSLC/Equivalent 10th Standard School certificate
Pre‚ÄźUniversity Course/ Higher Secondary
Name of the Entrance Exam taken
  Score Obtained :
  Percentile score:
 

Valid Till              :

If the applicant is not an Indian citizen, furnish the following particulars:
Passport No
  Valid till :
Visa Category
Visa No
  Valid till :

Parent / Guardian Details

Name of the Parent / Guardian
Occupation
Annual Income
Telephone Number Landline  :
  Mobile      :
  Email       :

Medium of Instruction
Hostel Facility required
   

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